Provider Demographics
NPI:1013111533
Name:TESSIE T. SY,DDS, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TESSIE T. SY,DDS, A PROFESSIONAL CORPORATION
Other - Org Name:TESSIE T. SY,DDS, A PROFESSIONAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TESSIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-350-3371
Mailing Address - Street 1:4565 PECK RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-1960
Mailing Address - Country:US
Mailing Address - Phone:626-350-3371
Mailing Address - Fax:860-371-3295
Practice Address - Street 1:4565 PECK RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-1960
Practice Address - Country:US
Practice Address - Phone:626-350-3371
Practice Address - Fax:860-371-3295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental