Provider Demographics
NPI:1407019979
Name:TRAN, PHU K (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHU
Middle Name:K
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 1:206 W AMBERWAY LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-8803
Mailing Address - Country:US
Mailing Address - Phone:214-293-7961
Mailing Address - Fax:
Practice Address - Street 1:201 S GREENVILLE AVE STE 108
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6069
Practice Address - Country:US
Practice Address - Phone:972-699-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-05
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist