Provider Demographics
NPI:1508231143
Name:HWANG, EUNHAE (DMD)
Entity Type:Individual
Prefix:
First Name:EUNHAE
Middle Name:
Last Name:HWANG
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 1:36 CHAUNCY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2209
Mailing Address - Country:US
Mailing Address - Phone:617-338-5000
Mailing Address - Fax:
Practice Address - Street 1:36 CHAUNCY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2209
Practice Address - Country:US
Practice Address - Phone:617-338-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857142122300000X
RIDEN03292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist