Provider Demographics
NPI:1124247093
Name:KELVIN C TSOI DDS MPH CORP
Entity type:Organization
Organization Name:KELVIN C TSOI DDS MPH CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TSOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MDH
Authorized Official - Phone:626-288-7667
Mailing Address - Street 1:6141 TEMPLE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1748
Mailing Address - Country:US
Mailing Address - Phone:626-288-7667
Mailing Address - Fax:626-288-6346
Practice Address - Street 1:8951 GLENDON WAY
Practice Address - Street 2:GLENROSE DENTAL GROUP
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1807
Practice Address - Country:US
Practice Address - Phone:626-288-7667
Practice Address - Fax:626-288-6346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty