MEDICARE: SANG T. TRAN, DDS, PLLC

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	122300000X	Dentist	25012	TX

General Provider Information

NPI Number	:	1952791410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANG T. TRAN, DDS, PLLC

Provider Business Mailing Address
First Line	:	2305 WORTHINGTON ST
Second Line	:	#112
City	:	DALLAS
State	:	TX
Zip	:	75204-2744
Country	:	US
Telephone Number	:	408-375-5914
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 N FITZHUGH AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-3315
Country	:	US
Telephone Number	:	408-375-5914
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	SANG TRAN
Credential	:	DDS
Telephone Number	:	408-375-5914

Provider Enumeration Date	:	02/04/2015
Last Update Date	:	02/04/2015

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