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General NPI Number Information
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NPI Number | 1629573993
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Entity Type | Individual
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Provider Name | JOHN BOSCO TRAN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 27949 JUBAN RD
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-7915
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Country | US
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Telephone | 225-243-7704
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Fax |
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Provider Business Mailing Address
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Address Line | 11425 N EASTERLYN CIR
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City | NEW ORLEANS
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State | LA
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Zip | 70128-5203
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Country | US
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Telephone | 504-610-2502
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6934
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | LA
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