Provider Demographics
NPI:1588700090
Name:HOANG, TO-NGUYEN THI (DMD, PA)
Entity type:Individual
Prefix:
First Name:TO-NGUYEN
Middle Name:THI
Last Name:HOANG
Suffix:
Gender:F
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8190 JOG RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-2912
Mailing Address - Country:US
Mailing Address - Phone:561-732-8001
Mailing Address - Fax:561-732-8095
Practice Address - Street 1:8190 JOG RD
Practice Address - Street 2:SUITE 240
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-2912
Practice Address - Country:US
Practice Address - Phone:561-732-8001
Practice Address - Fax:561-732-8095
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN119991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice