| NPI | 1093309213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITUS TANG CEO 650-850-8502 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223D0004X Dentist Dentist Anesthesiologist |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-02-28 |
| Last Update Date | 2021-02-28 |