| NPI | 1023623865 |
|---|---|
| Doing Business As | TOOTH FAIRY COTTAGE |
| Entity Type | Organization |
| Authorized Contact | ANDREW NGUYEN Dentist/Owner 408-238-2647 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |