| NPI | 1093362188 |
|---|---|
| Doing Business As | TOOTH FAIRY COTTAGE |
| Entity Type | Organization |
| Authorized Contact | ANDREW NGYUEN Dentist/Owner 408-238-2647 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |