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General NPI Number Information
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NPI Number | 1003177635
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Entity Type | Individual
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Provider Name | LANEY TRAM MAI DDS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 10/13/2013
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Provider Practice Location Address
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Address Line | 315 N GALLOWAY AVE STE A
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City | MESQUITE
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State | TX
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Zip | 75149-4363
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Country | US
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Telephone | 818-963-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 315 N GALLOWAY AVE STE A
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City | MESQUITE
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State | TX
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Zip | 75149-4363
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Country | US
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Telephone | 818-963-0668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27883
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License Number State | TX
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