Provider Demographics
NPI:1528492485
Name:TRAN, THANH (DMD)
Entity type:Individual
Prefix:
First Name:THANH
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 PARKWOOD BLVD
Mailing Address - Street 2:APT#2209
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3585
Mailing Address - Country:US
Mailing Address - Phone:858-874-2490
Mailing Address - Fax:
Practice Address - Street 1:7001 PARKWOOD BLVD
Practice Address - Street 2:APT#2209
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3585
Practice Address - Country:US
Practice Address - Phone:858-874-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist