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General NPI Number Information
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NPI Number | 1871811984
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Entity Type | Organization
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Legal Business Name | AITRANG T. TRAN DENTAL INCORPORATED
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 709 N. HILL STREET #9
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City | LA
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State | CA
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Zip | 90012
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Country | US
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Telephone | 213-626-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 709 N HILL ST #9
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City | LOS ANGELES
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State | CA
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Zip | 90012-2361
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Country | US
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Telephone | 213-626-1515
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | AITRANG TRAN
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Credential | D.D.S
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Telephone | 213-626-1515
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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 | 41139
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License Number State | CA
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