Provider Demographics
NPI:1700328895
Name:TSAI & SNOWDEN PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:TSAI & SNOWDEN PROFESSIONAL DENTAL CORPORATION
Other - Org Name:ESTHETIC PARTNERS DENTAL CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:G
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:323-722-4892
Practice Address - Street 1:8247 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2527
Practice Address - Country:US
Practice Address - Phone:562-692-1600
Practice Address - Fax:323-722-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty