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General NPI Number Information
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NPI Number | 1073656781
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Entity Type | Organization
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Legal Business Name | PHIL TRINH, DDS.,INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12302 GARDEN GROVE BLVD STE 1
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1833
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Country | US
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Telephone | 714-534-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 12302 GARDEN GROVE BLVD STE 1
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1833
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Country | US
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Telephone | 714-534-9292
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHIL TRINH
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Credential |
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Telephone | 714-534-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | B2420502
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License Number State | CA
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