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Organization
ROSITA D. TAN DMD, INC
Active
Organization
ROSITA D. TAN DMD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSITA D TAN DMD (OWNER)
(310) 822-8481
Entity
Organization
Contact information
Practice address
4560 ADMIRALTY WAY, SUITE 350, MARINA DEL REY, CA 90292-5423
(310) 822-8481
(310) 822-8083
Mailing address
4560 ADMIRALTY WAY, SUITE 350, MARINA DEL REY, CA 90292-5423
(310) 822-8481
(310) 822-8083
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40027
CA
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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