Individual
TAM SY TRUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11635 SOUTH ST, CERRITOS, CA 90701-6628
(562) 485-9994
Mailing address
10151 KUKUI DR, HUNTINGTON BEACH, CA 92646-2556
(714) 873-2558
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30795
—
CA
Enumeration date
05/20/2019
Last updated
05/20/2019
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