MEDICARE: MARGARITA DENTAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	44371	CA

General Provider Information

NPI Number	:	1225241227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGARITA DENTAL GROUP

Provider Business Mailing Address
First Line	:	39400 MURRIETA HOT SPRINGS RD
Second Line	:	SUITE 123-B
City	:	MURRIETA
State	:	CA
Zip	:	92563-7707
Country	:	US
Telephone Number	:	951-461-7470
Fax Number	:	951-461-7480

Provider Business Practice Location Address
First Line	:	39400 MURRIETA HOT SPRINGS RD
Second Line	:	SUITE 123-B
City	:	MURRIETA
State	:	CA
Zip	:	92563-7707
Country	:	US
Telephone Number	:	951-461-7470
Fax Number	:	951-461-7480

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HUEY Q TRAN
Credential	:	DDS
Telephone Number	:	951-461-7470

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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1760579080 — DR. HUEY TRAN DDS
Practice Location Address:

39400 MURRIETA HOT SPRINGS RD , SUITE 123B
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92563-7707

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