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General NPI Number Information
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NPI Number | 1356843759
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Entity Type | Organization
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Legal Business Name | ELIZABETH L TRAN DENTAL CORPORATION
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 1616 E 4TH ST
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City | SANTA ANA
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State | CA
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Zip | 92701-5160
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Country | US
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Telephone | 714-380-6675
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Fax |
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Provider Business Mailing Address
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Address Line | 3953 GALWAY BAY RD
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City | YORBA LINDA
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State | CA
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Zip | 92886-6123
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Country | US
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Telephone | 714-688-6625
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELIZABETH TRAN
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Credential | DMD
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Telephone | 714-688-6625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 49816
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License Number State | CA
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