Provider Demographics
NPI:1871677369
Name:DAVIDSSON, HUONG T (DDS)
Entity Type:Individual
Prefix:
First Name:HUONG
Middle Name:T
Last Name:DAVIDSSON
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 1:841 W 19TH ST
Mailing Address - Street 2:#C
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627
Mailing Address - Country:US
Mailing Address - Phone:949-642-2232
Mailing Address - Fax:949-645-2390
Practice Address - Street 1:841 W 19TH ST
Practice Address - Street 2:#C
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627
Practice Address - Country:US
Practice Address - Phone:949-642-2232
Practice Address - Fax:949-645-2390
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice