| NPI | 1376193862 |
|---|---|
| Doing Business As | TIFFANY CHAN, DDS |
| Entity Type | Organization |
| Authorized Contact | TIFFANY CHAN MODY President 408-248-4426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |