Provider Demographics
NPI:1457482929
Name:TRANS DENTAL CARE, INC
Entity Type:Organization
Organization Name:TRANS DENTAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:LUU
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-699-5760
Mailing Address - Street 1:1062 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2134
Mailing Address - Country:US
Mailing Address - Phone:781-767-2100
Mailing Address - Fax:
Practice Address - Street 1:1062 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2134
Practice Address - Country:US
Practice Address - Phone:781-767-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty