Provider Demographics
NPI:1881800258
Name:TON, TRUC T (DMD)
Entity type:Individual
Prefix:DR
First Name:TRUC
Middle Name:T
Last Name:TON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 SE BRISTOL PARK DR.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266
Mailing Address - Country:US
Mailing Address - Phone:503-772-0625
Mailing Address - Fax:503-772-2272
Practice Address - Street 1:9116 SE BRISTOL PARK DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-9143
Practice Address - Country:US
Practice Address - Phone:503-772-0625
Practice Address - Fax:503-772-2272
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist