Provider Demographics
NPI:1245516517
Name:AILAN TRAN, D.D.S., A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:AILAN TRAN, D.D.S., A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINH
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-528-7878
Mailing Address - Street 1:1374 E HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0833
Mailing Address - Country:US
Mailing Address - Phone:408-626-9566
Mailing Address - Fax:408-626-9366
Practice Address - Street 1:1374 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0833
Practice Address - Country:US
Practice Address - Phone:408-626-9566
Practice Address - Fax:408-626-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty