Provider Demographics
NPI:1821275694
Name:TRAN, DAVID KHUONG (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KHUONG
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7100 KENNEDY BLVD E
Mailing Address - Street 2:APT. 12K
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4717
Mailing Address - Country:US
Mailing Address - Phone:201-662-0977
Mailing Address - Fax:
Practice Address - Street 1:600 VALLEY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3535
Practice Address - Country:US
Practice Address - Phone:973-633-0097
Practice Address - Fax:973-633-5029
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ22DI021743001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics