Provider Demographics
NPI:1285899179
Name:HWANG, TOBIAS J (DDS)
Entity type:Individual
Prefix:DR
First Name:TOBIAS
Middle Name:J
Last Name:HWANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 15TH ST
Mailing Address - Street 2:#2H
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2032
Mailing Address - Country:US
Mailing Address - Phone:703-727-6608
Mailing Address - Fax:
Practice Address - Street 1:1963 GRAND CONCOURSE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4994
Practice Address - Country:US
Practice Address - Phone:718-294-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053908-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice