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General NPI Number Information
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NPI Number | 1902299472
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Entity Type | Individual
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Provider Name | JESSICA TN TRUONG DDS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 520 STERN WAY
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City | CARLSBAD
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State | CA
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Zip | 92011
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Country | US
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Telephone | 619-972-1046
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Fax |
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Provider Business Mailing Address
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Address Line | 520 STERN WAY
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City | CARLSBAD
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State | CA
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Zip | 92011
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Country | US
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Telephone | 619-972-1046
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 39993
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License Number State | CA
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