Provider Demographics
NPI:1801220009
Name:TRAN, DAVID PHILIP (DMD, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PHILIP
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WALLACE CIR
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2855
Mailing Address - Country:US
Mailing Address - Phone:617-785-5788
Mailing Address - Fax:
Practice Address - Street 1:130 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-2504
Practice Address - Country:US
Practice Address - Phone:617-785-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233180183500000X
CA63359183500000X
MADN1857243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No122300000XDental ProvidersDentist