Provider Demographics
NPI:1811169568
Name:LONG DANG TRAN D.D.S., INC.
Entity type:Organization
Organization Name:LONG DANG TRAN D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LONG
Authorized Official - Middle Name:DANG
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-264-1114
Mailing Address - Street 1:51 N HIGHLAND AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1434
Mailing Address - Country:US
Mailing Address - Phone:619-264-1114
Mailing Address - Fax:619-264-1111
Practice Address - Street 1:51 N HIGHLAND AVE
Practice Address - Street 2:SUITE F
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1434
Practice Address - Country:US
Practice Address - Phone:619-264-1114
Practice Address - Fax:619-264-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty