Provider Demographics
NPI:1922022045
Name:TRAN, AMY THU (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:THU
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 1:1321 COLLEGE ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4706
Mailing Address - Country:US
Mailing Address - Phone:530-668-6381
Mailing Address - Fax:
Practice Address - Street 1:1321 COLLEGE ST.
Practice Address - Street 2:SUITE B
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4706
Practice Address - Country:US
Practice Address - Phone:530-668-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice