Provider Demographics
NPI:1588043160
Name:LUAN K. TRAN, DDS. PC. INC
Entity Type:Organization
Organization Name:LUAN K. TRAN, DDS. PC. INC
Other - Org Name:ASPEN FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:307-324-3839
Mailing Address - Street 1:PO BOX 1039
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-1039
Mailing Address - Country:US
Mailing Address - Phone:307-324-3839
Mailing Address - Fax:307-324-3399
Practice Address - Street 1:1101 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5211
Practice Address - Country:US
Practice Address - Phone:307-324-3839
Practice Address - Fax:307-324-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY13221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty