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General NPI Number Information
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NPI Number | 1942422100
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Entity Type | Organization
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Legal Business Name | THUYVAN HOANG TRAN, DDS,INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 20940 ROSCOE BLVD
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City | CANOGA PARK
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State | CA
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Zip | 91304-4308
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Country | US
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Telephone | 818-882-8025
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Fax | 818-882-8027
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Provider Business Mailing Address
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Address Line | 20940 ROSCOE BLVD
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City | CANOGA PARK
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State | CA
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Zip | 91304-4308
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Country | US
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Telephone | 818-882-8025
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Fax | 818-882-8027
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Authorized Official
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Title or Position | CEO
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Name | DR. THUYVAN HOANG TRAN
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Credential | DDS
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Telephone | 818-882-8025
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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 | 42705
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License Number State | CA
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