MEDICARE: ANH H 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	13228	TX

General Provider Information

NPI Number	:	1760687511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANH H TRUONG DDS

Provider Business Mailing Address
First Line	:	8610 N LAMAR BLVD
Second Line	:	104
City	:	AUSTIN
State	:	TX
Zip	:	78753-5547
Country	:	US
Telephone Number	:	512-339-3196
Fax Number	:	512-339-3196

Provider Business Practice Location Address
First Line	:	8610 N LAMAR BLVD
Second Line	:	104
City	:	AUSTIN
State	:	TX
Zip	:	78753-5547
Country	:	US
Telephone Number	:	512-339-3196
Fax Number	:	512-339-3196

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2007

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