Organization Name: | TIEP M. TRAN DDS INC. |
NPI Number: | 1013336866 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HUNG XUAN DINH (PRESIDENT) |
Mailing Address: | 12732 Brookhurst St Garden Grove |
State: | CA US |
Postal Code: | 928404810 |
Phone Number: | 7145398899 |
Fax Number: | 7145398999 |
NPI Enumeration Date: | 04/09/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 49300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |