Provider Demographics
NPI:1851545537
Name:TRAM, CHONWAY DALY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHONWAY
Middle Name:DALY
Last Name:TRAM
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 1:230 E 17TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3824
Mailing Address - Country:US
Mailing Address - Phone:949-645-0045
Mailing Address - Fax:
Practice Address - Street 1:230 E 17TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3824
Practice Address - Country:US
Practice Address - Phone:949-645-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-08
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA576811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice