Provider Demographics
NPI:1568717460
Name:HA, CUONG HUY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CUONG
Middle Name:HUY
Last Name:HA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 W WILLIAM CANNON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5287
Mailing Address - Country:US
Mailing Address - Phone:512-912-9750
Mailing Address - Fax:512-693-0774
Practice Address - Street 1:2500 W WILLIAM CANNON DR STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5287
Practice Address - Country:US
Practice Address - Phone:512-912-9750
Practice Address - Fax:512-693-0774
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX279981223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics