Provider Demographics
NPI:1598132938
Name:B. TRAN DDS & ASSOCIATES, MOON VALLEY DENTISTRY PLLC
Entity Type:Organization
Organization Name:B. TRAN DDS & ASSOCIATES, MOON VALLEY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-993-3744
Mailing Address - Street 1:1930 W THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023
Mailing Address - Country:US
Mailing Address - Phone:602-993-3744
Mailing Address - Fax:602-993-3745
Practice Address - Street 1:1930 W THUNDERBIRD RD
Practice Address - Street 2:STE #116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-6369
Practice Address - Country:US
Practice Address - Phone:602-993-3744
Practice Address - Fax:602-993-3745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty