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General NPI Number Information
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NPI Number | 1336632447
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Entity Type | Organization
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Legal Business Name | TSAI HB DDS INC
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 20932 BROOKHURST ST STE 103
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-6685
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Country | US
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Telephone | 714-962-3319
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Fax |
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Provider Business Mailing Address
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Address Line | 20932 BROOKHURST ST STE 103
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-6685
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Country | US
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Telephone | 714-642-0205
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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. MATTHEW TSAI
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Credential | DDS
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Telephone | 714-962-3319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 41564
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License Number State | CA
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