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General NPI Number Information
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NPI Number | 1891021895
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Entity Type | Organization
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Legal Business Name | HENRY TRAN, DDS, APDC
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 4616 EL CAJON BLVD STE 8
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City | SAN DIEGO
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State | CA
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Zip | 92115-4426
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Country | US
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Telephone | 619-280-0076
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Fax | 619-280-3526
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Provider Business Mailing Address
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Address Line | 4616 EL CAJON BLVD STE 8
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City | SAN DIEGO
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State | CA
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Zip | 92115-4426
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Country | US
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Telephone | 619-280-0076
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Fax | 619-280-3526
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | HENRY TRAN
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Credential | DDS
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Telephone | 619-280-0076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 53955
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License Number State | CA
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