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Wilson Tam
Pediatric Dentist in Santee, California
NPI 1467947572

Wilson Tam is a Pediatric Dentist based in San Diego, CA and is specialized in Pediatric Dentistry. Wilson Tam practices in Santee, CA. The NPI Number for Wilson Tam is 1467947572 and holds a License No. 061312 (California).

The current practice location address for Wilson Tam is 110 Town Center Pkwy Ste A, Santee, CA and can be reached out via phone at 619-396-2477.

Location: 110 Town Center Pkwy Ste A, Santee, CA, 92108-5212
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467947572
Provider Name
Wilson Tam
Credential
Provider Entity Type
Individual
Gender
Male
Address
110 Town Center Pkwy Ste A, Santee, CA, 92108-5212
Phone Number
619-396-2477
Fax Number
Provider Enumeration Date
06/30/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Town Center Pkwy Ste A
City
Santee
State
California
Zip
92071-5801
Phone Number
619-396-2477
Fax Number
person
Provider Business Mailing Address Details
Address
110 Town Center Pkwy Ste A
City
Santee
State
California
Zip
92071-5801
Phone Number
619-396-2477
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
(New York)
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.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
061312 (New York)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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