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Michelle Ta, DMD
Pediatric Dentist in San Rafael, California
NPI 1124643739

Michelle Ta is a Pediatric Dentist based in San Jose, CA and is specialized in Pediatric Dentistry. Michelle Ta practices in San Rafael, CA and has the professional credentials of DMD. The NPI Number for Michelle Ta is 1124643739 and holds a License No. DDS104671 (California).

The current practice location address for Michelle Ta is 912 Grand Ave Ste 202, San Rafael, CA and can be reached out via phone at 408-717-0888.

Location: 912 Grand Ave Ste 202, San Rafael, CA, 95138-1851
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124643739
Provider Name
Michelle Ta
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
912 Grand Ave Ste 202, San Rafael, CA, 95138-1851
Phone Number
408-717-0888
Fax Number
Provider Enumeration Date
06/09/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
912 Grand Ave Ste 202
City
San Rafael
State
California
Zip
94901-3552
Phone Number
408-717-0888
Fax Number
person
Provider Business Mailing Address Details
Address
912 Grand Ave Ste 202
City
San Rafael
State
California
Zip
94901-3552
Phone Number
408-717-0888
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DDS104671 (California)
Definition
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.
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