1692 Tully Dentistry

LBN: 1692 Tully Dentistry
1692 Tully Dentistry is an health care organization with primary practice located at 2114 Senior Road Suite 25, San Jose CA 95112. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. 1692 Tully Dentistry can be contacted via phone (408) 279-2114, or through Nguyen, Phung Kim via phone (408) 279-2114.

Contact Information

Primary practice address
2114 Senior Road Suite 25 San Jose CA 95112
Phone: (408) 279-2114
Fax: (408) 279-1828
Website:
Map and Directions
Authorized official contact:
Name: Nguyen, Phung Kim
Phone: (408) 279-2114

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 44749 California

Profile Details

NPI number 1649406133
LBN Legal business name 1692 Tully Dentistry
DBA Doing business as
Authorized official Nguyen, Phung Kim
Entity Organization
Organization subpart 1 No
Enumeration date Jun 10th, 2009
Last updated Jun 10th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers