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General NPI Number Information
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NPI Number | 1497176713
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Entity Type | Organization
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Legal Business Name | TSAI & SNOWDEN, ESTHETIC PARTNERS DENTAL GROUP
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Dates
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Enumeration Date | 01/06/2014
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 415 W BEVERLY BLVD STE B
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City | MONTEBELLO
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State | CA
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Zip | 90640-3667
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Country | US
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Telephone | 323-724-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 415 W BEVERLY BLVD STE B
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City | MONTEBELLO
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State | CA
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Zip | 90640-3667
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Country | US
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Telephone | 323-724-3800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLLIN TSAI
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Credential | DDS
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Telephone | 323-724-3800
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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 | 59994
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 59994
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 58983
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License Number State | CA
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