Provider Demographics
NPI:1114167079
Name:ALAFAYA DENTAL CARE
Entity Type:Organization
Organization Name:ALAFAYA DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:THAI-HOA
Authorized Official - Last Name:HOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-366-8989
Mailing Address - Street 1:2984 ALAFAYA TRL STE 2030
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7628
Mailing Address - Country:US
Mailing Address - Phone:407-366-8989
Mailing Address - Fax:407-359-6381
Practice Address - Street 1:2984 ALAFAYA TRL STE 2030
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7628
Practice Address - Country:US
Practice Address - Phone:407-366-8989
Practice Address - Fax:407-359-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159841223G0001X
FLDN171571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty