Provider Demographics
NPI:1780770644
Name:TRAN, TRIET (DDS)
Entity type:Individual
Prefix:
First Name:TRIET
Middle Name:
Last Name:TRAN
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 1:3200 N MACARTHUR BLVD
Mailing Address - Street 2:STE 212
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:972-258-5959
Mailing Address - Fax:972-258-0509
Practice Address - Street 1:3200 N MACARTHUR BLVD
Practice Address - Street 2:STE 212
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:972-258-5959
Practice Address - Fax:972-258-0509
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19959122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist