Provider Demographics
NPI:1508915315
Name:TRAN, DUYEN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:DUYEN
Middle Name:M
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9949 DELAMERE DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-8507
Mailing Address - Country:US
Mailing Address - Phone:216-346-3965
Mailing Address - Fax:
Practice Address - Street 1:2417 PARK HILL DR
Practice Address - Street 2:SUITE B
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-2200
Practice Address - Country:US
Practice Address - Phone:817-921-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice