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General NPI Number Information
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NPI Number | 1629371281
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Entity Type | Individual
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Provider Name | TRAM DUONG DDS
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Gender | Female
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 2800 LYELL SPENCERPORT RD # A
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City | SPENCERPORT
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State | NY
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Zip | 14559-1977
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Country | US
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Telephone | 585-352-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PLEASANT ST APT 703
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City | ROCHESTER
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State | NY
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Zip | 14604-1455
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Country | US
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Telephone | 310-482-9519
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 055255
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License Number State | NY
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