Provider Demographics
NPI:1497176713
Name:TSAI & SNOWDEN, ESTHETIC PARTNERS DENTAL GROUP
Entity Type:Organization
Organization Name:TSAI & SNOWDEN, ESTHETIC PARTNERS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-724-3800
Mailing Address - Street 1:415 W BEVERLY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3667
Mailing Address - Country:US
Mailing Address - Phone:323-724-3800
Mailing Address - Fax:
Practice Address - Street 1:415 W BEVERLY BLVD STE B
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3667
Practice Address - Country:US
Practice Address - Phone:323-724-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59994122300000X, 1223P0700X
CA589831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty