Provider Demographics
NPI:1073690897
Name:TRUONG, RICK (DMD)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 CAMINO ARROYO
Mailing Address - Street 2:SUITE 50
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7342
Mailing Address - Country:US
Mailing Address - Phone:408-476-3245
Mailing Address - Fax:
Practice Address - Street 1:6955 CAMINO ARROYO
Practice Address - Street 2:SUITE 50
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7342
Practice Address - Country:US
Practice Address - Phone:408-476-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice