Provider Demographics
NPI:1033364427
Name:JEFFREY J TUFAROLO DDS PS
Entity Type:Organization
Organization Name:JEFFREY J TUFAROLO DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TUFAROLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-258-2834
Mailing Address - Street 1:3624 COLBY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4789
Mailing Address - Country:US
Mailing Address - Phone:425-258-2834
Mailing Address - Fax:
Practice Address - Street 1:3624 COLBY AVE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4789
Practice Address - Country:US
Practice Address - Phone:425-258-2834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5203261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental