Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PON T TATH, D.M.D.
ActivePON T TATH, D.M.D. is a General Dentistry healthcare provider located in BOONVILLE, California. NPI 1225260623 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · BOONVILLE, CA
Registration Details
- NPI Number
- 1225260623
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 18, 2009 (16.98661058955 yrs)
- Last Updated
- Dec 9, 2019
- License
-
58706 (CA)
Practice Information
- Address
-
13500 AIRPORT RDBOONVILLE, CA, 954159133Browse CA providers · Browse ZIP 95415
- Phone
- 7078953477
- Fax
- 7078952035
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.