Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 8036 | NC |
Y | 1223G0001X | General Practice | DN1856777 | MA |
Y | 213EG0000X | General Practice | DN1856777 | MA |
NPI | 1346240942 |
---|---|
Provider Name | Dr. Maria Magdelena Tran |
First Address | Gastonia, NC 28052-6430 |
Second Address | Brockton, MA 02302-3363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 07/02/2019 |