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Individual

PAUL TRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
516 E. NIZHONI BLVD, GALLUP, NM 87301

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401415331
VA
122300000X
Dentist
16032
MD
122300000X
Dentist
DEN1001642
DC

Other

Enumeration date
08/30/2016
Last updated
03/17/2018
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