| Ailan Dental Care | |
|
2042 Tully Rd San Jose CA 95122-1357 | |
| (408) 528-7878 | |
| Not Available |
| Full Name | Ailan Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2042 Tully Rd, San Jose, California |
| Authorized Official Name and Position | Vinh Le (VICE PRESIDENT) |
| Authorized Official Contact | 4085287878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ailan Dental Care 2042 Tully Rd San Jose CA 95122-1357 Ph: (408) 528-7878 | Ailan Dental Care 2042 Tully Rd San Jose CA 95122-1357 Ph: (408) 528-7878 |
| NPI Number | 1790803310 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790803310 | NPI | - | NPPES |
| 43502 | Other | CA | STATE LICENCE |
| G91512-01 | Medicaid | CA | |
| D43502 | Medicaid | CA | |
| 516896 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43502 (California) | Primary |
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