Provider Demographics
NPI:1619309622
Name:TRUONG, TRAMY THUY (DMD)
Entity Type:Individual
Prefix:
First Name:TRAMY
Middle Name:THUY
Last Name:TRUONG
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 1:7833 W DONALD DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3140
Mailing Address - Country:US
Mailing Address - Phone:602-432-4492
Mailing Address - Fax:
Practice Address - Street 1:9915 W MCDOWELL RD
Practice Address - Street 2:STE. 105
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4896
Practice Address - Country:US
Practice Address - Phone:623-907-4562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD008810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist