Provider Demographics
NPI:1609820885
Name:TRUONG, RICHARD NGOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NGOC
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5162 ALDINE MAIL ROUTE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-3802
Mailing Address - Country:US
Mailing Address - Phone:281-219-1819
Mailing Address - Fax:281-219-2060
Practice Address - Street 1:5162 ALDINE MAIL ROUTE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-3802
Practice Address - Country:US
Practice Address - Phone:281-219-1819
Practice Address - Fax:281-219-2060
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice