| Premier Dental Practice | |
|
1057 E Capitol Expwy San Jose CA 95121-2415 | |
| (408) 972-2911 | |
| (408) 972-2911 |
| Full Name | Premier Dental Practice |
|---|---|
| Speciality | Dentist |
| Location | 1057 E Capitol Expwy, San Jose, California |
| Authorized Official Name and Position | Camtam Tong Nguyen (OWNER) |
| Authorized Official Contact | 4089722911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental Practice 1057 E Capitol Expwy San Jose CA 95121-2415 Ph: (408) 972-2911 | Premier Dental Practice 1057 E Capitol Expwy San Jose CA 95121-2415 Ph: (408) 972-2911 |
| NPI Number | 1154523603 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154523603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 47648 (California) | Primary |
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