Provider Demographics
NPI:1366797003
Name:VALENCIA FAMILY DENTAL CARE
Entity type:Organization
Organization Name:VALENCIA FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAW
Authorized Official - Middle Name:M
Authorized Official - Last Name:THU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-773-9300
Mailing Address - Street 1:345 S EUCLID ST
Mailing Address - Street 2:SUITE-A
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2122
Mailing Address - Country:US
Mailing Address - Phone:714-773-9300
Mailing Address - Fax:
Practice Address - Street 1:345 S EUCLID ST
Practice Address - Street 2:SUITE-A
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2122
Practice Address - Country:US
Practice Address - Phone:714-773-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZAW M. THU,DDS, A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty