Individual
BRENT P TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10217 125TH STREET CT E, 3RD FLOOR, PUYALLUP, WA 98374-2761
(253) 864-4760
(253) 864-4558
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0112
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
63977
CA
1223G0001X
General Practice Dentistry
DE00009519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0174963
STATE LABOR & INDUSTRIES
WA
01
—
4352TR
REGENCE BLUE SHIELD
WA
05
—
5044540
—
WA
Enumeration date
10/27/2006
Last updated
06/06/2024
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