Provider Demographics
NPI:1740578210
Name:CONLEY, TRANG THU (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRANG
Middle Name:THU
Last Name:CONLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11044 STRAYHORN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-2449
Mailing Address - Country:US
Mailing Address - Phone:972-798-3121
Mailing Address - Fax:
Practice Address - Street 1:3501 GUS THOMASSON RD
Practice Address - Street 2:STE 105
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3699
Practice Address - Country:US
Practice Address - Phone:972-388-1138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice