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General NPI Number Information
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NPI Number | 1972372985
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Entity Type | Organization
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Legal Business Name | KENNETH TRAN DENTAL CORP
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 16299 PARAMOUNT BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-5425
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Country | US
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Telephone | 562-531-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 20913 NEW HAMPSHIRE AVE
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City | TORRANCE
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State | CA
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Zip | 90502-1753
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Country | US
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Telephone | 678-964-4969
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH TRAN
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Credential | DDS
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Telephone | 678-964-4969
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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 |
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License Number State |
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