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General NPI Number Information
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NPI Number | 1205030269
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Entity Type | Organization
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Legal Business Name | ANDY TRAN DDS & ASSOCIATES
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 433 ESTUDILLO AVE STE 108
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4915
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Country | US
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Telephone | 510-483-1266
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Fax | 510-483-1363
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Provider Business Mailing Address
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Address Line | 433 ESTUDILLO AVE STE 108
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4915
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Country | US
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Telephone | 510-483-1266
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Fax | 510-483-1363
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANDY M TRAN
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Credential | D.D.S
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Telephone | 510-483-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 43500
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License Number State | CA
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