| Tanaka Dental Corporation | |
|
212 Church Ave Suite A Chula Vista CA 91910-2703 | |
| (619) 420-8696 | |
| (619) 420-6915 |
| Full Name | Tanaka Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 212 Church Ave, Chula Vista, California |
| Authorized Official Name and Position | Katherine M Tanaka (OWNER) |
| Authorized Official Contact | 6194208696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanaka Dental Corporation 212 Church Ave Suite A Chula Vista CA 91910-2703 Ph: (619) 420-8696 | Tanaka Dental Corporation 212 Church Ave Suite A Chula Vista CA 91910-2703 Ph: (619) 420-8696 |
| NPI Number | 1619069929 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619069929 | NPI | - | NPPES |
| 166470 | Other | CA | UNITED CONDORDIA ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39210 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 40575 (California) | Secondary |
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