| Ktam Dds Dental Corp | |
|
1505 Shepard Dr #201 Santa Maria CA 93454-7020 | |
| (949) 322-9778 | |
| Not Available |
| Full Name | Ktam Dds Dental Corp |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1505 Shepard Dr, Santa Maria, California |
| Authorized Official Name and Position | Keith Tam (CEO) |
| Authorized Official Contact | 9493229778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ktam Dds Dental Corp 1505 Shepard Dr #201 Santa Maria CA 93454-7020 Ph: (949) 322-9778 | Ktam Dds Dental Corp 1505 Shepard Dr #201 Santa Maria CA 93454-7020 Ph: (949) 322-9778 |
| NPI Number | 1609181858 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 10/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609181858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 57293 (California) | Primary |
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