Provider Demographics
NPI:1245094770
Name:AREA DENTAL, TRUONG DENTAL OFFICE PC
Entity type:Organization
Organization Name:AREA DENTAL, TRUONG DENTAL OFFICE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-333-1907
Mailing Address - Street 1:560 N SAN JACINTO ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3128
Mailing Address - Country:US
Mailing Address - Phone:951-765-3174
Mailing Address - Fax:951-568-1146
Practice Address - Street 1:560 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3128
Practice Address - Country:US
Practice Address - Phone:951-765-3174
Practice Address - Fax:951-568-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty