Provider Demographics
NPI:1952540551
Name:SANG QUANG TRAN, DDS, INC
Entity Type:Organization
Organization Name:SANG QUANG TRAN, DDS, INC
Other - Org Name:VARSITY DENTISTRY-DENTAL PRACTICE OF SANG TRAN, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:Q
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-758-7996
Mailing Address - Street 1:1756 PICASSO AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-0549
Mailing Address - Country:US
Mailing Address - Phone:530-758-7996
Mailing Address - Fax:888-975-1541
Practice Address - Street 1:1756 PICASSO AVE
Practice Address - Street 2:SUITE D
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-0549
Practice Address - Country:US
Practice Address - Phone:530-758-7996
Practice Address - Fax:888-975-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty