Provider Demographics
NPI:1609963974
Name:TRAN, ANTHONY TRONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:TRONG
Last Name:TRAN
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 1:7877 PARKWAY DR
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2000
Mailing Address - Country:US
Mailing Address - Phone:619-463-6758
Mailing Address - Fax:
Practice Address - Street 1:7877 PARKWAY DR
Practice Address - Street 2:SUITE 2B
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2000
Practice Address - Country:US
Practice Address - Phone:619-463-6758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice