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General NPI Number Information
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NPI Number | 1366518474
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Entity Type | Individual
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Provider Name | MY- ANH TRAN DMD
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 13048 W RANCHO SANTA FE BLVD STE 114
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City | AVONDALE
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State | AZ
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Zip | 85392-1707
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Country | US
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Telephone | 623-536-3377
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Fax | 623-536-3088
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Provider Business Mailing Address
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Address Line | 13048 W RANCHO SANTA FE BLVD STE 114
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City | AVONDALE
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State | AZ
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Zip | 85392-1707
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Country | US
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Telephone | 623-536-3377
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Fax | 623-536-3088
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 55021
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D06970
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License Number State | AZ
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