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General NPI Number Information
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NPI Number | 1437408465
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Entity Type | Individual
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Provider Name | TIMMY HIEU TRUONG D.D.S
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Gender | Male
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 10226 WESTMINSTER AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-534-4311
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Fax | 714-534-4322
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Provider Business Mailing Address
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Address Line | 10226 WESTMINSTER AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-534-4311
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Fax | 714-534-4322
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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 | 65012
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License Number State | CA
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