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General NPI Number Information
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NPI Number | 1225650583
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Entity Type | Individual
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Provider Name | MISS DAO TIEN TRUONG
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Gender | Female
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Dates
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Enumeration Date | 05/09/2020
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Last Update Date | 05/09/2020
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Provider Practice Location Address
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Address Line | 5162 WHITTIER BLVD
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City | EAST LOS ANGELES
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State | CA
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Zip | 90022-3932
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Country | US
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Telephone | 323-510-5920
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Fax |
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Provider Business Mailing Address
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Address Line | 3221 FALLING LEAF AVE
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City | ROSEMEAD
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State | CA
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Zip | 91770-2430
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Country | US
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Telephone | 626-409-8187
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | RDA73684
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License Number State | CA
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