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General NPI Number Information
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NPI Number | 1265167548
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Entity Type | Individual
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Provider Name | DAVID TRUONG DMD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 2140 LAKE EUSTIS DR
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City | TAVARES
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State | FL
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Zip | 32778-2064
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Country | US
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Telephone | 352-268-1810
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 N ORANGE BLOSSOM TRL UNIT 120
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City | ORLANDO
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State | FL
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Zip | 32804-4808
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Country | US
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Telephone | 631-703-5150
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 27338
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License Number State | FL
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