Provider Demographics
NPI:1376889246
Name:HUEY TRAN DDS, INC.
Entity type:Organization
Organization Name:HUEY TRAN DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:VII
Authorized Official - Credentials:
Authorized Official - Phone:951-302-7508
Mailing Address - Street 1:33321 TEMECULA PKWY
Mailing Address - Street 2:#104
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4848
Mailing Address - Country:US
Mailing Address - Phone:951-302-7508
Mailing Address - Fax:951-302-7593
Practice Address - Street 1:33321 TEMECULA PKWY
Practice Address - Street 2:#104
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4848
Practice Address - Country:US
Practice Address - Phone:951-302-7508
Practice Address - Fax:951-302-7593
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUEY TRAN DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty