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General NPI Number Information
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NPI Number | 1952741530
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Entity Type | Organization
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Legal Business Name | HMS DENTAL PLLC
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 22717 S ELLSWORTH RD STE B102
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7575
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Country | US
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Telephone | 480-888-9596
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Fax | 480-882-1042
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Provider Business Mailing Address
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Address Line | 22717 S ELLSWORTH RD STE B102
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7575
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Country | US
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Telephone | 480-888-9596
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Fax | 480-882-1042
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HAI Q TRANG
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Credential | DDS
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Telephone | 480-888-9596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 6177
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License Number State | AZ
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