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General NPI Number Information
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NPI Number | 1649437518
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Entity Type | Organization
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Legal Business Name | CARLSBADDS PEDIATRIC SMILES
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 1285 CARLSBAD VILLAGE DR
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City | CARLSBAD
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State | CA
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Zip | 92008-1950
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Country | US
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Telephone | 760-730-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 1285 CARLSBAD VILLAGE DR
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City | CARLSBAD
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State | CA
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Zip | 92008-1950
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Country | US
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Telephone | 760-730-3456
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Fax |
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Authorized Official
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Title or Position | FINANCIAL MANAGER
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Name | MR. JAMES H TSAI
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Credential |
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Telephone | 626-379-6694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 51449
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License Number State | CA
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