| Vicheth Thay, Dds, Inc. | |
|
18250 Roscoe Blvd Ste 230 Northridge CA 91325-4269 | |
| (818) 885-1981 | |
| (818) 885-1937 |
| Full Name | Vicheth Thay, Dds, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 18250 Roscoe Blvd Ste 230, Northridge, California |
| Authorized Official Name and Position | Vicheth Thay (DENTIST) |
| Authorized Official Contact | 8188851981 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicheth Thay, Dds, Inc. 18250 Roscoe Blvd Ste 230 Northridge CA 91325-4269 Ph: (818) 885-1981 | Vicheth Thay, Dds, Inc. 18250 Roscoe Blvd Ste 230 Northridge CA 91325-4269 Ph: (818) 885-1981 |
| NPI Number | 1124224779 |
|---|---|
| Provider Enumeration Date | 06/21/2007 |
| Last Update Date | 07/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124224779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 46531 (California) | Primary |
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