| NPI | 1114319027 |
|---|---|
| Former Legal Business Name | JUSTIN DUC-TIEN PROFESSIONAL |
| Entity Type | Organization |
| Authorized Contact | JUSTIN TRAN Dentist 714-821-0973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49686) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2019-09-16 |