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Organization
DR. JACK MA, DDS, INC.
Active
Organization
DR. JACK MA, DDS, INC.
Active
Other names
Dr. Tooth Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK T. MA D.D.S. (DENTIST)
(626) 286-1568
Entity
Organization
Contact information
Practice address
9093 LAS TUNAS DR, TEMPLE CITY, CA 91780-1901
(626) 286-1568
(626) 286-9738
Mailing address
9093 LAS TUNAS DR, TEMPLE CITY, CA 91780-1901
(626) 286-1568
(626) 286-9738
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B40666-01
DENTI-CAL PROVIDER ID
CA
Enumeration date
01/25/2007
Last updated
04/29/2016
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