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Individual

HOA TRAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7935 CONSTITUTION AVE STE 110, COLORADO SPRINGS, CO 80951-8903
(719) 596-9668
Mailing address
4415 SW 34TH ST APT 101, GAINESVILLE, FL 32608-1448
(352) 665-1420

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00204715
CO
1223G0001X
General Practice Dentistry
DEN00204751
CO

Other

Enumeration date
06/01/2021
Last updated
06/02/2021
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