MEDICARE: ANH N TRAN DENTAL CORP

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	261QD0000X	Dental Clinic/Center	545357557	CA

General Provider Information

NPI Number	:	1336406370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANH N TRAN DENTAL CORP

Provider Business Mailing Address
First Line	:	6965 BROADWAY
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945
Country	:	US
Telephone Number	:	480-735-8839
Fax Number	:

Provider Business Practice Location Address
First Line	:	6965 BROADWAY
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-1405
Country	:	US
Telephone Number	:	480-735-8839
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANH N TRAN
Credential	:	DDS
Telephone Number	:	480-735-8839

Provider Enumeration Date	:	04/16/2012
Last Update Date	:	04/16/2012

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Directions to “ANH N TRAN DENTAL CORP ” Practice Location

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