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General NPI Number Information
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NPI Number | 1821306929
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Entity Type | Organization
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Legal Business Name | TSAI, HSIAO & LOO DENTAL CORPORATION
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 1000 VENICE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90015-3232
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Country | US
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Telephone | 213-748-8810
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Fax | 213-748-8813
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Provider Business Mailing Address
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Address Line | PO BOX 93122
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City | LONG BEACH
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State | CA
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Zip | 90809-3122
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Country | US
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Telephone | 562-424-6200
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Fax | 562-981-5074
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW TSAI
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Credential | DDS
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Telephone | 562-981-5002
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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 | 41564
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License Number State | CA
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