Provider Demographics
NPI:1720172570
Name:TRUONG, HUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:HUNG
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2501 W INTERSTATE 20
Mailing Address - Street 2:100
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3947
Mailing Address - Country:US
Mailing Address - Phone:972-660-8457
Mailing Address - Fax:972-660-8459
Practice Address - Street 1:2501 W INTERSTATE 20
Practice Address - Street 2:100
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3947
Practice Address - Country:US
Practice Address - Phone:972-660-8457
Practice Address - Fax:972-660-8459
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice