| Rosita D Tan Dmd Inc. | |
|
4560 Admiralty Way Suite 350 Marina Del Rey CA 90292-5423 | |
| (310) 822-8481 | |
| (310) 822-8083 |
| Full Name | Rosita D Tan Dmd Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4560 Admiralty Way, Marina Del Rey, California |
| Authorized Official Name and Position | Rosita D Tan (PRESIDENT) |
| Authorized Official Contact | 3108228481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosita D Tan Dmd Inc. 4560 Admiralty Way Suite 350 Marina Del Rey CA 90292 Ph: (310) 822-8481 | Rosita D Tan Dmd Inc. 4560 Admiralty Way Suite 350 Marina Del Rey CA 90292-5423 Ph: (310) 822-8481 |
| NPI Number | 1255505533 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 09/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255505533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40027 (California) | Primary |
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