Tan, Rosita
Tan, Rosita is an individual health care provider with primary practice located at 4560 Admiralty Way Ste 350, Marina Del Rey CA 90292-5423. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Tan, Rosita can be contacted via phone (310) 822-8481.Contact Information
Primary practice address
4560 Admiralty Way Ste 350
Marina Del Rey CA 90292-5423
Phone: (310) 822-8481
Fax: (310) 822-8083
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 40027 | California |
Profile Details
| NPI number | 1245625847 |
|---|---|
| LBN Legal business name | Tan, Rosita |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2015 |
| Last updated | Mar 31st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245625847 | NPPES |
| California | Other | 40027 | DENTAL BOARD LICENSE |
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