Organization
NGUYEN AND TA PROFESSIONAL DENTAL CORP.
Active
Other names
Thai Ta, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAI THUY TA DDS (SECRETARY)
(626) 337-4440
Entity
Organization
Contact information
Practice address
1740 W CAMERON AVE STE 106, WEST COVINA, CA 91790-2719
(626) 337-4440
(626) 337-4460
Mailing address
1740 W CAMERON AVE STE 106, WEST COVINA, CA 91790-2719
(626) 337-4440
(626) 337-4460
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
45530
CA
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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