Individual
MISS TRA PHAM THANH TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
68 STAFFORD ST, WORCESTER, MA 01603-1450
(508) 770-0900
Mailing address
12602 SHELLEY DR APT 9, GARDEN GROVE, CA 92840-4933
(714) 234-4351
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859585
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2022
Last updated
09/14/2022
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