Mikhai C. Ta, Dds, Ps

NPI #1003117946 in Centralia, Washington

Provider Information

NPI Number: 1003117946
Entity Type: Organization
Organization Name: Mikhai C. Ta, Dds, Ps
Primary Specialty: Dentist
Enumeration Date: Nov 9, 2010
Last Updated: Jun 24, 2011

Practice Location

Address: 1211 S GOLD ST
City: Centralia
State: Washington
ZIP Code: 98531-3715
Phone: (360) 736-5040

Authorized Official

Name: DR. MIKHAI CONG TA, DDS
Title: OWNER
Phone: (909) 936-1803

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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