Provider Demographics
NPI:1124220454
Name:TISOT & TISOT
Entity Type:Organization
Organization Name:TISOT & TISOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:TISOT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-428-8822
Mailing Address - Street 1:820 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2520
Mailing Address - Country:US
Mailing Address - Phone:856-428-8822
Mailing Address - Fax:
Practice Address - Street 1:820 KINGS HWY S
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2520
Practice Address - Country:US
Practice Address - Phone:856-428-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty