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General NPI Number Information
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NPI Number | 1558143826
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Entity Type | Organization
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Legal Business Name | KURT TRUONG, DDS, MSD, PLLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 14201 NE 20TH AVE STE C102
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City | VANCOUVER
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State | WA
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Zip | 98686-6414
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Country | US
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Telephone | 360-573-3176
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Fax | 360-573-3716
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Provider Business Mailing Address
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Address Line | 14201 NE 20TH AVE STE C102
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City | VANCOUVER
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State | WA
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Zip | 98686-6414
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Country | US
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Telephone | 360-573-3176
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Fax | 360-573-3716
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Authorized Official
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Title or Position | OWNER
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Name | KURT TRUONG, DDS, MSD
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Credential | DDS, MSD
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Telephone | 360-573-3176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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