Provider Demographics
NPI:1811012750
Name:HOANG, CHAU (DMD)
Entity Type:Individual
Prefix:
First Name:CHAU
Middle Name:
Last Name:HOANG
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 1:40 CUMBERLAND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4445
Mailing Address - Country:US
Mailing Address - Phone:508-399-8800
Mailing Address - Fax:508-399-7744
Practice Address - Street 1:40 CUMBERLAND AVE STE 5
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4445
Practice Address - Country:US
Practice Address - Phone:508-399-8800
Practice Address - Fax:508-399-7744
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA196811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA19681OtherLICENSE