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General NPI Number Information
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NPI Number | 1689750390
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Entity Type | Individual
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Provider Name | BRENT P TRAN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 10217 125TH STREET CT E 3RD FLOOR
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City | PUYALLUP
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State | WA
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Zip | 98374-2761
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Country | US
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Telephone | 253-864-4760
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Fax | 253-864-4558
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Provider Business Mailing Address
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Address Line | PO BOX 34703
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City | SEATTLE
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State | WA
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Zip | 98124-1703
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Country | US
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Telephone | 206-764-0112
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Fax | 206-764-0489
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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 | 63977
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00009519
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License Number State | WA
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