MEDICARE: SILVIE THU-HIEN QUACH, D.D.S., A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	43065	CA

General Provider Information

NPI Number	:	1063624708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVIE THU-HIEN QUACH, D.D.S., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	88 WEST TULLY RD.
Second Line	:	103
City	:	SAN JOSE
State	:	CA
Zip	:	95111
Country	:	US
Telephone Number	:	510-965-9000
Fax Number	:	510-965-9009

Provider Business Practice Location Address
First Line	:	404 SAN PABLO TOWNE CTR
Second Line	:
City	:	SAN PABLO
State	:	CA
Zip	:	94806-3933
Country	:	US
Telephone Number	:	510-965-9000
Fax Number	:	510-965-9009

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SILVIE THU-HIEN QUACH
Credential	:	D.D.S.
Telephone Number	:	510-965-9000

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	04/23/2008

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