| |
1647 E Palmdale Blvd Suite K Palmdale CA 93550-4877 | |
(661) 273-5301 | |
(661) 273-2668 |
Full Name | |
---|---|
Speciality | Dentist |
Location | 1647 E Palmdale Blvd, Palmdale, California |
Authorized Official Name and Position | Quan Nhut Tran (DENTIST) |
Authorized Official Contact | 6612735301 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1647 E Palmdale Blvd Suite K Palmdale CA 93550-4877 Ph: (661) 273-5301 | 1647 E Palmdale Blvd Suite K Palmdale CA 93550-4877 Ph: (661) 273-5301 |
NPI Number | 1831318575 |
---|---|
Provider Enumeration Date | 04/24/2007 |
Last Update Date | 09/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831318575 | NPI | - | NPPES |
B4804901 | Other | CA | MEDICAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 48049 (California) | Primary |