Provider Demographics
NPI:1194399865
Name:TON, QUANG L (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUANG
Middle Name:L
Last Name:TON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 CASCADES DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-5005
Mailing Address - Country:US
Mailing Address - Phone:214-909-4185
Mailing Address - Fax:
Practice Address - Street 1:986 N MITTHOEFER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2622
Practice Address - Country:US
Practice Address - Phone:317-899-3106
Practice Address - Fax:317-899-3141
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013592A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice