Pon T Tath, DMD is a
Dentist - General Practice based in Boonville, California. Pon T Tath is licensed to practice in California (license number 58706) and his current practice location is
13500 Airport Rd, Boonville, California. He can be reached at his office (for appointments etc.) via phone at
(707) 895-3477.
NPI number for Pon T Tath is 1225260623 and his current mailing address is Po Box 7783, Stockton, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225260623.
Healthcare Provider's Profile
Full Name | Pon T Tath |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 13500 Airport Rd, Boonville, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1225260623
- Provider Enumeration Date: 08/18/2009
- Last Update Date: 12/09/2019
Medical Identifiers
Medical identifiers for Pon T Tath such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225260623 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 58706 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pon T Tath is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Pon T Tath, DMD Po Box 7783, Stockton, CA 95267-0783 Ph: (209) 597-3145 | Pon T Tath, DMD 13500 Airport Rd, Boonville, CA 95415-9133 Ph: (707) 895-3477 |
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