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General NPI Number Information
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NPI Number | 1528305265
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Entity Type | Organization
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Legal Business Name | TERRIE X TRAN DDS PC
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 10545 S EASTERN AVE STE 140
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City | HENDERSON
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State | NV
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Zip | 89052-3973
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Country | US
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Telephone | 702-492-9399
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Fax | 702-492-6326
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Provider Business Mailing Address
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Address Line | 10545 S. EASTERN AVE 140
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City | HENDERSON
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State | NV
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Zip | 89052-3973
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Country | US
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Telephone | 702-492-9399
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Fax | 702-492-6326
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SANDRA LEE DESPIGANOVICZ
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Credential |
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Telephone | 702-492-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4178
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License Number State | NV
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