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Individual
DR. AN TA
Active
Individual
DR. AN TA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11130
TN
1223G0001X
General Practice Dentistry
30.025140
OH
1223G0001X
General Practice Dentistry
34378
TX
Other
Enumeration date
10/19/2017
Last updated
03/22/2023
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