MEDICARE: THUYTIEN TON, D.D.S., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	42382	CA

General Provider Information

NPI Number	:	1922057595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THUYTIEN TON, D.D.S., INC

Provider Business Mailing Address
First Line	:	10371 PRATHER LN
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92782-1437
Country	:	US
Telephone Number	:	714-272-2708
Fax Number	:

Provider Business Practice Location Address
First Line	:	10371 PRATHER LN
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92782-1437
Country	:	US
Telephone Number	:	714-272-2708
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER/PRESIDENT
Name	:	THUYTIEN TON
Credential	:	DDS
Telephone Number	:	714-272-2708

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	10/19/2020

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