Individual
JIA TIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
393 BLOSSOM HILL RD STE 150, SAN JOSE, CA 95123
(408) 629-3366
Mailing address
393 BLOSSOM HILL RD STE 150, SAN JOSE, CA 95123-1655
(510) 901-1312
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
102957
CA
Other
Enumeration date
08/06/2018
Last updated
07/23/2019
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