Provider Demographics
NPI:1467897454
Name:NOH, DONGHYUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONGHYUN
Middle Name:
Last Name:NOH
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 1:555 PROVIDENCE HWY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-4230
Mailing Address - Country:US
Mailing Address - Phone:508-734-7056
Mailing Address - Fax:
Practice Address - Street 1:555 PROVIDENCE HWY UNIT 2
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-4230
Practice Address - Country:US
Practice Address - Phone:508-734-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice