Organization
THE HEALTH TRUSR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL TAI D.D.S (DENTAL CLINIC DIRECTOR)
(408) 879-8423
Entity
Organization
Contact information
Practice address
2085 HAMILTON AVE, SUITE 150, SAN JOSE, CA 95125-6117
(408) 559-9385
Mailing address
2085 HAMILTON AVE, SUITE 150, SAN JOSE, CA 95125-6117
(408) 559-9385
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
9149301
CA
1223P0221X
Pediatric Dentistry
Primary
9149302
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G91493-01
DENTI-CAL
CA
01
—
G91493-02
DENTI-CAL
CA
Enumeration date
08/08/2006
Last updated
08/22/2020
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