| Thai Ta, Dds | |
|
1740 W Cameron Ave Ste 106 West Covina CA 91790-2719 | |
| (626) 337-4440 | |
| (626) 337-4460 |
| Full Name | Thai Ta, Dds |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1740 W Cameron Ave Ste 106, West Covina, California |
| Authorized Official Name and Position | Thai Thuy Ta (SECRETARY) |
| Authorized Official Contact | 6263374440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thai Ta, Dds 1740 W Cameron Ave Ste 106 West Covina CA 91790-2719 Ph: (626) 337-4440 | Thai Ta, Dds 1740 W Cameron Ave Ste 106 West Covina CA 91790-2719 Ph: (626) 337-4440 |
| NPI Number | 1942370317 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942370317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 45530 (California) | Primary |
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