| NPI | 1346105392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN PHAN Owner 408-835-3726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223E0200X Dentist, Endodontics | |
| 122300000X Dentist | |
| Enumeration Date | 2025-12-22 |
| Last Update Date | 2025-12-23 |