Provider Demographics
NPI:1790230498
Name:TRAN, RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
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 1:1909 N MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-3366
Mailing Address - Country:US
Mailing Address - Phone:724-769-3609
Mailing Address - Fax:
Practice Address - Street 1:1909 N MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-3366
Practice Address - Country:US
Practice Address - Phone:724-769-3609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice