Provider Demographics
NPI:1538493200
Name:HOANG, VICORIA L (DDS)
Entity Type:Individual
Prefix:
First Name:VICORIA
Middle Name:L
Last Name:HOANG
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 1:1887 BUSINESS CENTER DR STE 2B
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3400
Mailing Address - Country:US
Mailing Address - Phone:909-890-2611
Mailing Address - Fax:909-890-4620
Practice Address - Street 1:1887 BUSINESS CENTER DR STE 2B
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3400
Practice Address - Country:US
Practice Address - Phone:909-890-2611
Practice Address - Fax:909-890-4620
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44893122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist