Provider Demographics
NPI:1952302945
Name:HWANG, HONGSOK (DDS)
Entity Type:Individual
Prefix:DR
First Name:HONGSOK
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 BROAD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1637
Mailing Address - Country:US
Mailing Address - Phone:201-941-8087
Mailing Address - Fax:201-941-8068
Practice Address - Street 1:669 BROAD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1637
Practice Address - Country:US
Practice Address - Phone:201-941-8087
Practice Address - Fax:201-941-8068
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI21002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist