Provider Demographics
NPI:1326498429
Name:HOANG, COURTNEY (DMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HOANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LEE AIRPARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-1239
Mailing Address - Country:US
Mailing Address - Phone:410-956-4608
Mailing Address - Fax:
Practice Address - Street 1:15 LEE AIRPARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1239
Practice Address - Country:US
Practice Address - Phone:410-956-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD159801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice