Provider Demographics
NPI:1033233580
Name:LETRAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:LETRAN DENTAL CORPORATION
Other - Org Name:UNIVERSAL FAMILY DENTAL PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LETRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-433-1300
Mailing Address - Street 1:10012 GARVEY AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2086
Mailing Address - Country:US
Mailing Address - Phone:626-433-1300
Mailing Address - Fax:626-433-1330
Practice Address - Street 1:10012 GARVEY AVE STE 11
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2086
Practice Address - Country:US
Practice Address - Phone:626-433-1300
Practice Address - Fax:626-433-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty