Provider Demographics
NPI:1164771135
Name:THAI-SON TRAN DMD, PC
Entity Type:Organization
Organization Name:THAI-SON TRAN DMD, PC
Other - Org Name:GENUINE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THAI-SON
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-743-9958
Mailing Address - Street 1:3306 W CAMP WISDOM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-2554
Mailing Address - Country:US
Mailing Address - Phone:972-709-4867
Mailing Address - Fax:972-709-4869
Practice Address - Street 1:3306 W CAMP WISDOM RD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2554
Practice Address - Country:US
Practice Address - Phone:972-709-4867
Practice Address - Fax:972-709-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty