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General NPI Number Information
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NPI Number | 1598408593
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Entity Type | Organization
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Legal Business Name | RICHIE TRAN, DMD INC
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 1015 E ALESSANDRO BLVD STE 130
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City | RIVERSIDE
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State | CA
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Zip | 92508-2420
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Country | US
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Telephone | 626-374-1786
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Fax |
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Provider Business Mailing Address
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Address Line | 18945 CANCELA PL
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3814
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Country | US
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Telephone | 626-374-1786
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. RICHIE TRAN
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Credential | DMD
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Telephone | 626-374-1786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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