Provider Demographics
NPI:1841373388
Name:TRAN, THOMAS TD (DDS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:TD
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1122 E. LINCOLN AVENUE, SUITE 109
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865
Mailing Address - Country:US
Mailing Address - Phone:714-985-9800
Mailing Address - Fax:714-985-9816
Practice Address - Street 1:1122 E. LINCOLN AVENUE, SUITE 109
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865
Practice Address - Country:US
Practice Address - Phone:714-985-9800
Practice Address - Fax:714-985-9816
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice