Provider Demographics
NPI:1952400681
Name:TSE, KENNETH KAION JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:KAION
Last Name:TSE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1215 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1397
Mailing Address - Country:US
Mailing Address - Phone:650-871-5437
Mailing Address - Fax:650-873-2662
Practice Address - Street 1:1215 MISSION RD
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-1397
Practice Address - Country:US
Practice Address - Phone:650-871-5437
Practice Address - Fax:650-873-2662
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA457821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry