Provider Demographics
NPI:1790988004
Name:TRAN, MAI UYEN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAI UYEN
Middle Name:T
Last Name:TRAN
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 1:1360 BURTON DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3557
Mailing Address - Country:US
Mailing Address - Phone:707-685-9819
Mailing Address - Fax:
Practice Address - Street 1:1360 BURTON DR
Practice Address - Street 2:SUITE 120
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3557
Practice Address - Country:US
Practice Address - Phone:707-685-9819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry