Provider Demographics
NPI:1548464191
Name:TRAN, DUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:DUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 EL DORADO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2914
Mailing Address - Country:US
Mailing Address - Phone:831-647-1200
Mailing Address - Fax:831-648-8065
Practice Address - Street 1:243 EL DORADO ST STE 101
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2914
Practice Address - Country:US
Practice Address - Phone:831-647-1200
Practice Address - Fax:831-648-8065
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice