Individual provider · Type 1 NPI

Michelle Ta, DMD

Pediatric Dentistry · San Rafael, CA

NPI number 1124643739 Active

Practice location

912 Grand Ave Ste 202
San Rafael, CA 94901-3552

Call (408) 717-0888 Map

Mailing address

77 Tennant Ave
San Jose, CA 95138-1851

Specialties and licenses

TaxonomyCodeLicense
Pediatric Dentistry Primary 1223P0221XDDS104671 (CA)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

2 other providers at this address

Other pediatric dentistry providers in San Rafael

See all in San Rafael →

About NPI 1124643739

Michelle Ta, DMD's National Provider Identifier is 1124643739, issued on Jun 9, 2020. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in San Rafael, CA. The record was last updated on Jun 9, 2020.