Provider Demographics
NPI:1346381654
Name:TAM, JANICE CAROL (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:CAROL
Last Name:TAM
Suffix:
Gender:F
Credentials:DDS MSD
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Mailing Address - Street 1:2411 OCEAN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-2618
Mailing Address - Country:US
Mailing Address - Phone:415-508-9468
Mailing Address - Fax:415-859-5800
Practice Address - Street 1:2411 OCEAN AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2618
Practice Address - Country:US
Practice Address - Phone:415-508-9468
Practice Address - Fax:415-859-5800
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA350831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics