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General NPI Number Information
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NPI Number | 1932209723
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Entity Type | Individual
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Provider Name | LOC TRAN DDS
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3427 DEER PARK DRIVE SUITE A
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City | STOCKTON
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State | CA
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Zip | 95219
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Country | US
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Telephone | 120-947-8225
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Fax |
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Provider Business Mailing Address
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Address Line | 9994 VISCONTI COURT
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City | ELK GROVE
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State | CA
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Zip | 95757
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Country | US
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Telephone | 191-690-7876
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 45992
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License Number State | CA
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