Healthcare Provider Details

I. General information

NPI: 1528265113
Provider Name (Legal Business Name): HENRY HOANG TRAN,DMD,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 S KNOTT AVE
ANAHEIM CA
92804-2807
US

IV. Provider business mailing address

545 S KNOTT AVE
ANAHEIM CA
92804-2807
US

V. Phone/Fax

Practice location:
  • Phone: 714-828-1135
  • Fax: 714-828-1136
Mailing address:
  • Phone: 714-828-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: HENRY H TRAN
Title or Position: DETNTIST
Credential: DMD
Phone: 714-390-6762