MEDICARE: DR. VINCENT C 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
1	1223G0001X	General Practice Dentistry	17872	TX

General Provider Information

NPI Number	:	1548456791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT C TRAN D.D.S

Provider Business Mailing Address
First Line	:	14075 WATERFALL WAY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-3841
Country	:	US
Telephone Number	:	972-783-5711
Fax Number	:	972-783-5796

Provider Business Practice Location Address
First Line	:	14075 WATERFALL WAY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-3841
Country	:	US
Telephone Number	:	972-783-5711
Fax Number	:	972-783-5796

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

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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