| Edenvale Dental Group | |
|
120 Blossom Hill Rd Suite 20 San Jose CA 95123-2302 | |
| (408) 225-5883 | |
| (408) 225-8650 |
| Full Name | Edenvale Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 120 Blossom Hill Rd, San Jose, California |
| Authorized Official Name and Position | Mindi Chau Thai (CO-OWNER, PRESIDENT) |
| Authorized Official Contact | 4082255883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edenvale Dental Group 120 Blossom Hill Rd Suite 20 San Jose CA 95123-2302 Ph: (408) 225-5883 | Edenvale Dental Group 120 Blossom Hill Rd Suite 20 San Jose CA 95123-2302 Ph: (408) 225-5883 |
| NPI Number | 1639322688 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 11/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639322688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 49010 (California) | Primary |
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