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General NPI Number Information
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NPI Number | 1104437532
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Entity Type | Individual
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Provider Name | SEAN TRUONG DMD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 9061 W SAHARA AVE STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89117-5797
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Country | US
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Telephone | 702-877-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 9636 SWEET PALM CT
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City | LAS VEGAS
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State | NV
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Zip | 89178-8279
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Country | US
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Telephone | 702-417-3057
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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 | 7376
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License Number State | NV
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