Provider Demographics
NPI:1740339852
Name:HADUONG, HAN (DDS)
Entity type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:HADUONG
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 1:9450 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2426
Mailing Address - Country:US
Mailing Address - Phone:562-904-2157
Mailing Address - Fax:562-904-9588
Practice Address - Street 1:9450 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-2426
Practice Address - Country:US
Practice Address - Phone:562-904-2157
Practice Address - Fax:562-904-9588
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34967122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist