| NPI | 1164144879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN D HOANG Owner Dentist 848-250-2837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |