Provider Demographics
NPI:1194841999
Name:TSAI, HSIAO & LOO DENTAL CORPORATION
Entity Type:Organization
Organization Name:TSAI, HSIAO & LOO DENTAL CORPORATION
Other - Org Name:UNIVERSAL CARE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-424-6200
Mailing Address - Street 1:P.O BOX 93122
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90809
Mailing Address - Country:US
Mailing Address - Phone:800-635-6668
Mailing Address - Fax:562-424-9807
Practice Address - Street 1:4024 12TH ST.
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3561
Practice Address - Country:US
Practice Address - Phone:951-784-0636
Practice Address - Fax:951-784-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X
CA48503122300000X
CA41564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty