MEDICARE: HOA V TRINH 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	2362	NV

General Provider Information

NPI Number	:	1871633792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOA V TRINH D.D.S

Provider Business Mailing Address
First Line	:	2375 S JONES BLVD
Second Line	:	SUITE 12 A
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3169
Country	:	US
Telephone Number	:	702-365-6441
Fax Number	:	702-365-1812

Provider Business Practice Location Address
First Line	:	2375 S JONES BLVD
Second Line	:	SUITE 12 A
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3169
Country	:	US
Telephone Number	:	702-365-6441
Fax Number	:	702-365-1812

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/08/2007

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