Individual
VIET TON THAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2635 GATEWAY RD STE 101, CARLSBAD, CA 92009-1753
(760) 431-8112
Mailing address
2946 AVENIDA VALERA, CARLSBAD, CA 92009-7121
(408) 605-0543
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
51660
CA
1223P0300X
Periodontics
D9353
OR
Other
Enumeration date
10/02/2009
Last updated
01/03/2022
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