| Sambath Tiep DDS, PC | |
|
15725 Pomerado Rd Ste 206 Poway CA 92064-2059 | |
| (858) 251-3313 | |
| (858) 225-1803 |
| Full Name | Sambath Tiep DDS, PC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 15725 Pomerado Rd Ste 206, Poway, California |
| Authorized Official Name and Position | Sambath Tiep (OWNER/PRESIDENT) |
| Authorized Official Contact | 8582513313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sambath Tiep DDS, PC 15725 Pomerado Rd Ste 206 Poway CA 92064-2059 Ph: (858) 251-3313 | Sambath Tiep DDS, PC 15725 Pomerado Rd Ste 206 Poway CA 92064-2059 Ph: (858) 251-3313 |
| NPI Number | 1548804313 |
|---|---|
| Provider Enumeration Date | 11/04/2019 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548804313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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