Provider Demographics
NPI:1417173493
Name:WEST CHESTER FAMILY DENTISTRY, INC
Entity Type:Organization
Organization Name:WEST CHESTER FAMILY DENTISTRY, INC
Other - Org Name:PHUOC M. TRAN DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHUOC
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-755-2118
Mailing Address - Street 1:8919 BROOKSIDE CT
Mailing Address - Street 2:SUITE #102
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7109
Mailing Address - Country:US
Mailing Address - Phone:513-755-2118
Mailing Address - Fax:513-755-5732
Practice Address - Street 1:8919 BROOKSIDE CT
Practice Address - Street 2:SUITE #102
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7109
Practice Address - Country:US
Practice Address - Phone:513-755-2118
Practice Address - Fax:513-755-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30020426261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental