Provider Demographics
NPI:1437364098
Name:TRAN, QUYEN THUC (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUYEN
Middle Name:THUC
Last Name:TRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26318 NORMA JEAN PL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4900
Mailing Address - Country:US
Mailing Address - Phone:951-461-9921
Mailing Address - Fax:
Practice Address - Street 1:26318 NORMA JEAN PL
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4900
Practice Address - Country:US
Practice Address - Phone:951-461-9921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist