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NPI Code Detail

MEDICARE: TAN QUOC TRAN D.D.S.

MEDICARE: TAN QUOC TRAN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3505NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003977760
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAN QUOC TRAN D.D.S.
Provider Business Mailing Address
First Line : 737 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5384
Country : US
Telephone Number : 702-453-2337
Fax Number : 702-453-4706
Provider Business Practice Location Address
First Line : 737 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5384
Country : US
Telephone Number : 702-453-2337
Fax Number : 702-453-4706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 07/09/2007

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Directions to “ TAN QUOC TRAN D.D.S.” Practice Location

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