Provider Demographics
NPI:1811095052
Name:DUONG, TRANG THUY (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:TRANG
Middle Name:THUY
Last Name:DUONG
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:140 N FREMONT ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-4725
Mailing Address - Country:US
Mailing Address - Phone:209-824-7466
Mailing Address - Fax:209-824-7510
Practice Address - Street 1:140 N FREMONT ST
Practice Address - Street 2:SUITE C
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4725
Practice Address - Country:US
Practice Address - Phone:209-824-7466
Practice Address - Fax:209-824-7510
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics