Provider Demographics
NPI:1770829731
Name:HUEY TRAN DDS, INC.
Entity Type:Organization
Organization Name:HUEY TRAN DDS, INC.
Other - Org Name:ESPLANADE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:VII
Authorized Official - Credentials:
Authorized Official - Phone:951-487-2999
Mailing Address - Street 1:2191 W ESPLANADE AVE
Mailing Address - Street 2:#F106
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-3723
Mailing Address - Country:US
Mailing Address - Phone:951-487-2999
Mailing Address - Fax:951-487-9490
Practice Address - Street 1:2191 W ESPLANADE AVE
Practice Address - Street 2:#F106
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-3723
Practice Address - Country:US
Practice Address - Phone:951-487-2999
Practice Address - Fax:951-487-9490
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUEY TRAND DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44371122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty