MEDICARE: DR. RICHARD NGOC TRUONG 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	19879	TX

General Provider Information

NPI Number	:	1609820885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD NGOC TRUONG DDS

Provider Business Mailing Address
First Line	:	5162 ALDINE MAIL ROUTE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-3802
Country	:	US
Telephone Number	:	281-219-1819
Fax Number	:	281-219-2060

Provider Business Practice Location Address
First Line	:	5162 ALDINE MAIL ROUTE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-3802
Country	:	US
Telephone Number	:	281-219-1819
Fax Number	:	281-219-2060

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/01/2012

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