| Tuan T. Ly Dds, Inc | |
|
910 E Grand Ave A Escondido CA 92025-3430 | |
| (760) 745-0593 | |
| (760) 745-0633 |
| Full Name | Tuan T. Ly Dds, Inc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 910 E Grand Ave, Escondido, California |
| Authorized Official Name and Position | Tuan T Ly (CEO) |
| Authorized Official Contact | 7607450593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tuan T. Ly Dds, Inc 910 E Grand Ave A Escondido CA 92025-3430 Ph: (760) 745-0593 | Tuan T. Ly Dds, Inc 910 E Grand Ave A Escondido CA 92025-3430 Ph: (760) 745-0593 |
| NPI Number | 1003254004 |
|---|---|
| Provider Enumeration Date | 06/12/2013 |
| Last Update Date | 06/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003254004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 57169 (California) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 052343 (New York) | Primary |
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