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General NPI Number Information
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NPI Number | 1376836403
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Entity Type | Individual
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Provider Name | QUOC HOA TRAN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 5920 PARKWAY NORTH BLVD SUITE 100
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City | CUMMING
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State | GA
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Zip | 30040-8257
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Country | US
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Telephone | 770-889-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 NORTHMONT PKWY
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City | DULUTH
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State | GA
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Zip | 30097-4144
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Country | US
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Telephone | 404-966-7245
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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 | DN014254
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License Number State | GA
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