| NPI | 1831558352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITUS TANG CEO 650-755-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 52475) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 63855) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 60361) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |