Provider Demographics
NPI:1205987070
Name:HOA QUYNH DUONG D.D.S. & YEN HAI DUONG D.D.S., INC.
Entity type:Organization
Organization Name:HOA QUYNH DUONG D.D.S. & YEN HAI DUONG D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOA
Authorized Official - Middle Name:QUYNH
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-530-5517
Mailing Address - Street 1:13518 HARBOR BLVD STE A5
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3840
Mailing Address - Country:US
Mailing Address - Phone:714-530-5517
Mailing Address - Fax:714-530-6526
Practice Address - Street 1:13518 HARBOR BLVD
Practice Address - Street 2:A5
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3838
Practice Address - Country:US
Practice Address - Phone:714-530-5517
Practice Address - Fax:714-530-6526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35876261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental