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General NPI Number Information
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NPI Number | 1629052717
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Entity Type | Organization
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Legal Business Name | MINH TRAN DENTAL CORPORATION
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8736 VALLEY BLVD #B
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City | ROSEMEAD
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State | CA
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Zip | 91770-1760
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Country | US
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Telephone | 626-571-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 8736 VALLEY BLVD #B
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City | ROSEMEAD
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State | CA
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Zip | 91770-1760
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Country | US
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Telephone | 626-571-2324
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MR. MINH HONG TRAN
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Credential | DDS
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Telephone | 626-571-2324
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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 | DE31404
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License Number State | CA
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