Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 25456 | CA |
NPI | 1063658367 |
---|---|
Provider Name | Dr. Seng-Tiew Tan |
First Address | Santa Ana, CA 92706-2316 |
Second Address | Santa Ana, CA 92706-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2008 |
Last Update Date | 17/12/2008 |