Provider Demographics
NPI:1184886368
Name:JOU, TOM TEN (DDS)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:TEN
Last Name:JOU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W EMERSON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1669
Mailing Address - Country:US
Mailing Address - Phone:626-695-2410
Mailing Address - Fax:
Practice Address - Street 1:3065 S ARCHIBALD AVE STE B
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-9000
Practice Address - Country:US
Practice Address - Phone:909-923-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist