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NPI 1306445689

NPI 1306445689 : VU ANH TRAN DMD : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1306445689
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    Entity Type          |    Individual 
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    Provider Name        |    VU ANH TRAN DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/19/2020
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    Last Update Date     |    03/01/2022
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Provider Practice Location Address
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    Address Line         |    1672 MCKEE RD 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95116-1235
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    Country              |    US
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    Telephone            |    408-272-3999
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1672 MCKEE RD 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95116-1235
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    Country              |    US
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    Telephone            |    408-272-3999
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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       |    105714
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    License Number State |    CA
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