Provider Demographics
NPI:1205843950
Name:THAI, CHRISTINE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:C
Last Name:THAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL DR BLDG 1
Mailing Address - Street 2:UNIT #5
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-961-5070
Mailing Address - Fax:510-793-3782
Practice Address - Street 1:2500 HOSPITAL DR BLDG 1
Practice Address - Street 2:UNIT #5
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-961-5070
Practice Address - Fax:510-793-3782
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice