Individual
DR. THUYDUONG T TRUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MMSC
Contact information
Practice address
13297 BLACK MOUNTAIN RD STE 7, SAN DIEGO, CA 92129-2658
(858) 484-4707
Mailing address
13297 BLACK MOUNTAIN ROAD STE #7, SAN DIEGO, CA 92129
(858) 484-4707
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
48393
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G92455-01
DENTICAL PROVIDER NUMBER
CA
Enumeration date
02/23/2007
Last updated
07/08/2007
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