Organization
KEITH H TAM DDS INC
Active
Parent organization
KEITH TAM DDS PROFESSIONAL CORP
Other names
Lake Forest Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEITH TAM DDS PROFESSIONAL CORP
Authorized official
DR. KEITH H TAM DDS (OWNER, DDS)
(949) 322-9778
Entity
Organization
Contact information
Practice address
2674 SAN MIGUEL DR, NEWPORT BEACH, CA 92660-5437
(949) 478-6628
Mailing address
2674 SAN MIGUEL DR STE C, NEWPORT BEACH, CA 92660-5437
(949) 478-6628
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
57293
CA
Other
Enumeration date
11/07/2012
Last updated
01/27/2022
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