MEDICARE: DR. ANTHONY TRAN DDS

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
1	1223G0001X	General Practice Dentistry	34299	TX

General Provider Information

NPI Number	:	1174000160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY TRAN DDS

Provider Business Mailing Address
First Line	:	PO BOX 180056
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76096-0056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7664 MCCART AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-7803
Country	:	US
Telephone Number	:	817-346-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/29/2019

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