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General NPI Number Information
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NPI Number | 1114040110
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Entity Type | Individual
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Provider Name | ROSA TRAN DDS
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 16575 BROOKHURST ST STE A
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2357
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Country | US
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Telephone | 714-775-8303
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Fax | 714-775-7294
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Provider Business Mailing Address
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Address Line | 16575 BROOKHURST ST STE A
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2357
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Country | US
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Telephone | 714-775-8303
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Fax | 714-775-7294
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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 | 51662
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License Number State | CA
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