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DR. MINTRA TAN D.D.S.

Pediatric Dentistry >> Dentist >> Dental Providers

Registrant NPI Number: 1821249426

Individual Registrant:
DR. MINTRA  TAN D.D.S.
Gender: F
Sole Proprietor

Location and contact information for practice:
151 S MEDNIK AVE  EAST LOS ANGELES, CA 90022-1606 US
Tel: 323-263-3303  Fax: --

Contact information for business:
151 S MEDNIK AVE  EAST LOS ANGELES, CA 90022-1606 US
Tel: --  Fax: --

Registration Information:
NPI: 1821249426
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Dentist
Pediatric Dentistry
CA53108

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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