Healthcare Provider Details

I. General information

NPI: 1427684034
Provider Name (Legal Business Name): QUYNH TRAN DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2020
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 1ST ST
NORCO CA
92860-3140
US

IV. Provider business mailing address

1919 1ST ST
NORCO CA
92860-3140
US

V. Phone/Fax

Practice location:
  • Phone: 951-372-0775
  • Fax:
Mailing address:
  • Phone: 951-372-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. QUYNH N TRAN
Title or Position: OWNER
Credential: DDS
Phone: 951-372-0775