| NPI | 1013265602 |
|---|---|
| Doing Business As | TOOTH FAIRY COTTAGE |
| Entity Type | Organization |
| Authorized Contact | KIMDUNG TRACY TRAN Owner 408-238-2647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 51778) |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-04-30 |