Provider Demographics
NPI:1407831316
Name:TRUONG, CUC HOANG (DDS)
Entity Type:Individual
Prefix:
First Name:CUC
Middle Name:HOANG
Last Name:TRUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 WALNUT BEND
Mailing Address - Street 2:#14
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042
Mailing Address - Country:US
Mailing Address - Phone:281-487-7774
Mailing Address - Fax:281-487-1188
Practice Address - Street 1:5871 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3907
Practice Address - Country:US
Practice Address - Phone:281-487-7774
Practice Address - Fax:281-487-1188
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice