Provider Demographics
NPI:1689401903
Name:TAN, AARON CHRISTOPHER POBRE (DDS)
Entity type:Individual
Prefix:
First Name:AARON CHRISTOPHER
Middle Name:POBRE
Last Name:TAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 E EL MONTE WAY
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-9375
Mailing Address - Country:US
Mailing Address - Phone:559-591-4600
Mailing Address - Fax:
Practice Address - Street 1:2108 E EL MONTE WAY
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-9375
Practice Address - Country:US
Practice Address - Phone:559-591-4600
Practice Address - Fax:559-591-4800
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty