Vicheth Thay, Dds, Inc.

NPI #1124224779 in Northridge, California

Provider Information

NPI Number: 1124224779
Entity Type: Organization
Organization Name: Vicheth Thay, Dds, Inc.
Primary Specialty: Dentist
Enumeration Date: Jun 21, 2007
Last Updated: Jul 5, 2008

Practice Location

Address: 18250 ROSCOE BLVD STE 230
City: Northridge
State: California
ZIP Code: 91325-4269
Phone: (818) 885-1981

Authorized Official

Name: DR. VICHETH THAY, D.D.S.
Title: DENTIST
Phone: (818) 885-1981

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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