Provider Demographics
NPI:1437635463
Name:HONG, TONY (DMD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7562 S UNIVERSITY BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3160
Mailing Address - Country:US
Mailing Address - Phone:303-770-8278
Mailing Address - Fax:
Practice Address - Street 1:7562 S UNIVERSITY BLVD STE J
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3160
Practice Address - Country:US
Practice Address - Phone:303-770-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00203579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist