Individual
THEA DOSANJH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(585) 275-4360
Mailing address
P.O. BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4128
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
57740
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/20/2006
Last updated
02/08/2012
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