Organization
WEIDEMAN-TSE DENTAL CORPORATION
Active
Other names
Smile Island Pediatric & Adult Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELVIN A TSE DDS (OWNER)
(916) 773-6565
Entity
Organization
Contact information
Practice address
6522 LONETREE BLVD, ROCKLIN, CA 95765-5874
(916) 773-6565
(916) 773-6510
Mailing address
6522 LONETREE BLVD, ROCKLIN, CA 95765-5874
(916) 773-6565
(916) 773-6510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
37975
CA
1223P0221X
Pediatric Dentistry
Primary
37753
CA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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