ETHAN TA, DMD
Dentist
Active
Individual
NPI: 1376432302
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist | 122300000X | Yes | 111703 (CA) |
Frequently Asked Questions
NPI 1376432302 is the National Provider Identifier for ETHAN TA, DMD, a Dentist provider located in Camp Pendleton, CA. This NPI was enumerated on July 2, 2025.
ETHAN TA, DMD practices at 200 MERCY CIRCLE, Camp Pendleton, CA 92055.
Quick Facts
- NPI
- 1376432302
- Type
- Individual
- Enumerated
- Jul 2, 2025
- Last Updated
- Jul 2, 2025
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