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General NPI Number Information
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NPI Number | 1265018329
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Entity Type | Organization
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Legal Business Name | VIET TRAN DMD PC
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 1219 MONTAUK HWY
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City | OAKDALE
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State | NY
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Zip | 11769-1434
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Country | US
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Telephone | 631-563-7462
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 MONTAUK HWY
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City | OAKDALE
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State | NY
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Zip | 11769-1434
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Country | US
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Telephone | 631-563-7462
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIET TRAN
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Credential | DMD
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Telephone | 347-309-3729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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