Individual
JORDAN HOANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2034 N STATE ROUTE 50, BOURBONNAIS, IL 60914-4410
(815) 929-0222
Mailing address
16228 GROVE AVE, OAK FOREST, IL 60452-4109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033965
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/02/2022
Last updated
10/05/2022
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