Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 8814 | KY |
NPI | 1003195504 |
---|---|
Provider Name | Dr. Lan Tuyet Tran |
First Address | Louisville, KY 40241 |
Second Address | Louisville, KY 40241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2011 |
Last Update Date | 19/03/2015 |