Provider Demographics
NPI:1598896482
Name:TSAI, BRYCE K (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:K
Last Name:TSAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 N MOUNTAIN AVE
Mailing Address - Street 2:#205
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3669
Mailing Address - Country:US
Mailing Address - Phone:909-985-2757
Mailing Address - Fax:909-985-8137
Practice Address - Street 1:1152 N MOUNTAIN AVE
Practice Address - Street 2:#205
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3669
Practice Address - Country:US
Practice Address - Phone:909-985-2757
Practice Address - Fax:909-985-8137
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA485631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice