Individual
BAO TRUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1738 165TH ST, HAMMOND, IN 46320-2814
(219) 844-8000
Mailing address
1738 165TH ST, HAMMOND, IN 46320-2814
(219) 844-8000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032259
IL
122300000X
Dentist
Primary
12013784A
IN
Other
Enumeration date
07/25/2019
Last updated
11/11/2024
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