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General NPI Number Information
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NPI Number | 1760798896
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Entity Type | Individual
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Provider Name | TRIEU PHUOC TON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2199 MAIN ST
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City | OAKLEY
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State | CA
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Zip | 94561-3303
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Country | US
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Telephone | 925-600-8020
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Fax | 925-452-6323
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Provider Business Mailing Address
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Address Line | 6471 LONE TREE WAY STE 301
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City | BRENTWOOD
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State | CA
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Zip | 94513-5265
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Country | US
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Telephone | 925-453-2333
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Fax | 925-453-2326
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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 | 59481
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License Number State | CA
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