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General NPI Number Information
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NPI Number | 1225701154
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Entity Type | Organization
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Legal Business Name | COLLIN TSAI DDS INC
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 4028 CHICAGO AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5340
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Country | US
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Telephone | 951-328-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 4028 CHICAGO AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5340
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Country | US
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Telephone | 951-328-1166
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | COLLIN TSAI
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Credential |
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Telephone | 415-794-4279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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