NPI 1003117946

Mikhai C. Ta, DDS, Ps

Organisation Dentist Centralia, WA

Practice location

Address: 1211 S Gold St, Centralia, WA 98531-3715
Phone: (360) 736-5040
Fax: (360) 736-1979
Mailing address: PO Box 676, Centralia, WA 98531-0676

Authorised official

Name: Mikhai Cong Ta
Title: Owner
Phone: (909) 936-1803

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X

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Registry record

NPI: 1003117946
Entity type: Organization
NPI issued: 9 Nov 2010
Record last updated: 24 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.