Provider Demographics
NPI:1740911098
Name:HWANG, VINCENT C (DMD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:C
Last Name:HWANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 S ARIZONA AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-0917
Mailing Address - Country:US
Mailing Address - Phone:480-782-1555
Mailing Address - Fax:
Practice Address - Street 1:3885 S ARIZONA AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-0917
Practice Address - Country:US
Practice Address - Phone:480-782-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist