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Individual
TRACY ELLEN TRIEU
Active
Individual
TRACY ELLEN TRIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0442000537
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0442000537
VIRGINIA TEMPORARY DENTAL LICENSE
VA
05
—
362584290012
—
VA
Enumeration date
07/18/2024
Last updated
07/18/2024
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