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General NPI Number Information
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NPI Number | 1790803310
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Entity Type | Organization
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Legal Business Name | AILAN TRAN,D.D.S., A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2042 TULLY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-1357
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Country | US
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Telephone | 408-528-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 2042 TULLY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-1357
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Country | US
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Telephone | 408-528-7878
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. VINH LE
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Credential |
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Telephone | 408-528-7878
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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 | 43502
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License Number State | CA
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