NPI 1023372513

Pristine Dental, Vu Thanh Thai, DMD INC.

Organisation Preferred Provider Organization San Diego, CA

Practice location

Address: 3078 University Ave, San Diego, CA 92104-3034
Phone: (619) 295-8891
Fax: (619) 295-8896

Authorised official

Name: Vu Thanh Thai
Title: President
Phone: (619) 295-8891

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 56058 (CA)

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Registry record

NPI: 1023372513
Entity type: Organization
NPI issued: 28 Jun 2012
Record last updated: 28 Jun 2012

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.