Provider Demographics
NPI:1093104804
Name:TOWLE, TIZIANA PROCOPIO (DDS 48391 DENTIST)
Entity Type:Individual
Prefix:DR
First Name:TIZIANA
Middle Name:PROCOPIO
Last Name:TOWLE
Suffix:
Gender:F
Credentials:DDS 48391 DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595
Mailing Address - Country:US
Mailing Address - Phone:925-933-5677
Mailing Address - Fax:925-939-7650
Practice Address - Street 1:2229 OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595
Practice Address - Country:US
Practice Address - Phone:925-933-5677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice