Individual
TINA TALESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
34964
TX
122300000X
Dentist
D010939
AZ
1223G0001X
General Practice Dentistry
34964
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS105062
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2018
Last updated
01/01/2023
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