MEDICARE: CHAU M 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	19929	TX

General Provider Information

NPI Number	:	1700964640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAU M TRUONG DDS

Provider Business Mailing Address
First Line	:	1450 DEBBIE LN STE 130
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-5073
Country	:	US
Telephone Number	:	817-533-4755
Fax Number	:	713-349-8027

Provider Business Practice Location Address
First Line	:	1450 DEBBIE LN STE 130
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-5073
Country	:	US
Telephone Number	:	817-533-4755
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	11/01/2019

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