| Tk Dental Practice | |
|
2344 Mckee Road Suite 50 San Jose CA 95116-1616 | |
| (408) 251-0118 | |
| (408) 251-0119 |
| Full Name | Tk Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2344 Mckee Road, San Jose, California |
| Authorized Official Name and Position | Loc B Pham (DENTIST SECER SECRETARY) |
| Authorized Official Contact | 4082510118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tk Dental Practice 2344 Mckee Road Suite 50 San Jose CA 95116-1616 Ph: (408) 251-0118 | Tk Dental Practice 2344 Mckee Road Suite 50 San Jose CA 95116-1616 Ph: (408) 251-0118 |
| NPI Number | 1104911940 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104911940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 46515 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 46508 (California) | Secondary |
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