Provider Demographics
NPI:1912243882
Name:HUEY TRAN DDS, INC.
Entity Type:Organization
Organization Name:HUEY TRAN DDS, INC.
Other - Org Name:LIMONITE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:VII
Authorized Official - Credentials:
Authorized Official - Phone:951-360-2020
Mailing Address - Street 1:12363 LIMONITE AVE # F106
Mailing Address - Street 2:
Mailing Address - City:MIRA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91752-3685
Mailing Address - Country:US
Mailing Address - Phone:951-360-2020
Mailing Address - Fax:951-360-6633
Practice Address - Street 1:12363 LIMONITE AVE # F106
Practice Address - Street 2:
Practice Address - City:MIRA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91752-3685
Practice Address - Country:US
Practice Address - Phone:951-360-2020
Practice Address - Fax:951-360-6633
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUEY TRAN DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty