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Organization
TANAKA DENTAL CORPORATION
Active
Organization
TANAKA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE M TANAKA DDS (OWNER)
(619) 420-8696
Entity
Organization
Contact information
Practice address
212 CHURCH AVE, SUITE A, CHULA VISTA, CA 91910-2703
(619) 420-8696
(619) 420-6915
Mailing address
212 CHURCH AVE, SUITE A, CHULA VISTA, CA 91910-2703
(619) 420-8696
(619) 420-6915
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39210
CA
1223G0001X
General Practice Dentistry
40575
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166470
UNITED CONDORDIA ID#
CA
Enumeration date
09/28/2006
Last updated
08/22/2020
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