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General NPI Number Information
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NPI Number | 1093994857
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Entity Type | Organization
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Legal Business Name | TRINH TRAC DDS INC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 33448 ALVARADO NILES RD
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City | UNION CITY
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State | CA
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Zip | 94587-3110
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Country | US
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Telephone | 510-429-1178
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Fax | 510-429-1151
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Provider Business Mailing Address
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Address Line | 33448 ALVARADO NILES R.D.
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City | UNION CITY
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State | CA
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Zip | 94587-3110
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Country | US
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Telephone | 510-429-1178
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Fax | 510-429-1151
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRINH PHUONG TRAC
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Credential |
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Telephone | 510-862-9989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 54033
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License Number State | CA
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