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General NPI Number Information
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NPI Number | 1245602986
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Entity Type | Organization
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Legal Business Name | DENTSMILE DENTAL, CORPORATION
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 10226 WESTMINSTER AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-534-4311
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Fax | 714-534-4322
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Provider Business Mailing Address
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Address Line | 10226 WESTMINSTER AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-534-4311
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Fax | 714-534-4322
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMMY HIEU TRUONG
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Credential | D.D.S.
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Telephone | 714-534-4311
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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 | 65012
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License Number State | CA
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