MEDICARE: K. TRAN DENTAL CORPORATION

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	60561	CA

General Provider Information

NPI Number	:	1720498025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K. TRAN DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	1126 MEADOW LN
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94520-3706
Country	:	US
Telephone Number	:	925-808-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	1126 MEADOW LN
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94520-3706
Country	:	US
Telephone Number	:	925-451-2420
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, OWNER
Name	:	DR. KATIE DO
Credential	:	DDS
Telephone Number	:	925-451-2420

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	11/07/2016

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