Healthcare Provider Details

I. General information

NPI: 1578063889
Provider Name (Legal Business Name): TRAN DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S 4TH ST
MINERSVILLE PA
17954-1104
US

IV. Provider business mailing address

246 E GRAND AVE
TOWER CITY PA
17980-1124
US

V. Phone/Fax

Practice location:
  • Phone: 570-544-4845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA J TRAN
Title or Position: DENTIST
Credential: DMD
Phone: 717-649-5357