MEDICARE: DR. DUYEN M TRAN DMD

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	22149	TX

General Provider Information

NPI Number	:	1508915315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUYEN M TRAN DMD

Provider Business Mailing Address
First Line	:	9949 DELAMERE DR
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-8507
Country	:	US
Telephone Number	:	216-346-3965
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 PARK HILL DR
Second Line	:	SUITE B
City	:	FORT WORTH
State	:	TX
Zip	:	76110-2200
Country	:	US
Telephone Number	:	817-921-2900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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