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General NPI Number Information
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NPI Number | 1215799051
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Entity Type | Organization
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Legal Business Name | DANIEL TA DDS INC
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 4111 ALHAMBRA AVE
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City | MARTINEZ
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State | CA
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Zip | 94553-3823
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Country | US
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Telephone | 925-888-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 5261 SUSSEX PL
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City | NEWARK
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State | CA
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Zip | 94560-1953
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Country | US
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Telephone | 949-735-9756
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL TA
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Credential | DDS
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Telephone | 949-735-9756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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