Provider Demographics
NPI:1922429281
Name:TSE, FELIX (DDS)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:
Last Name:TSE
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 1:3635 N FREEWAY BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2926
Mailing Address - Country:US
Mailing Address - Phone:916-285-6691
Mailing Address - Fax:
Practice Address - Street 1:3635 N FREEWAY BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2926
Practice Address - Country:US
Practice Address - Phone:916-285-6691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA628311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice