Provider Demographics
NPI:1043339203
Name:TRAN, PAUL DAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S GLENOAKS BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1319
Mailing Address - Country:US
Mailing Address - Phone:818-842-4851
Mailing Address - Fax:818-842-5615
Practice Address - Street 1:303 S GLENOAKS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1319
Practice Address - Country:US
Practice Address - Phone:818-842-4851
Practice Address - Fax:818-842-5615
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice