Provider Demographics
NPI:1720323066
Name:TRANS DENTAL CARE A PROFESSIONAL
Entity type:Organization
Organization Name:TRANS DENTAL CARE A PROFESSIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-615-7334
Mailing Address - Street 1:10914 OLD HAMMOND HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8313
Mailing Address - Country:US
Mailing Address - Phone:225-615-7334
Mailing Address - Fax:225-615-7986
Practice Address - Street 1:10914 OLD HAMMOND HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8313
Practice Address - Country:US
Practice Address - Phone:225-615-7334
Practice Address - Fax:225-615-7986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1858293Medicaid
LA1855901Medicaid
LA1862801Medicaid