NPIMap

Peter Hwang, DDS

Individual provider Active NPI General Practice Dentistry · Fort Eisenhower, GA

NPI 1417519349 · NPPES record last updated Jun 21, 2024

Key facts

NPI
1417519349
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401416684 (VA)
Practice address
Eisenhower Army Medical Center
Hospital Dental Clinic
Fort Eisenhower, GA 30905
Phone
(706) 787-1937
NPI assigned
Jul 1, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401416684VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 0401416684 VA Yes

Addresses

Primary practice location

Eisenhower Army Medical Center
Hospital Dental Clinic
Fort Eisenhower, GA 30905

Mailing address

834 Lillian Park Dr
Grovetown, GA 30813-0710
Phone (706) 787-6927

Other practice location 1

Brian D. Allgood Army Community Hospital (BDAACH)
Unit 15245
Apo, AP 96271
Phone (315) 737-1219

Other practice location 2

618th Dental Co, Carius Dental Clinic
BLDG# P3020 ATTN: Credentials Office
Apo, AP 96271-5245
Phone (253) 968-4079

Other providers in Fort Eisenhower, GA

All providers in Fort Eisenhower, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.