Provider Demographics
NPI:1235294711
Name:TOBIAS, TIMOTHY SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:TOBIAS
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 1:1849 COMMERCENTER E
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3427
Mailing Address - Country:US
Mailing Address - Phone:909-884-4741
Mailing Address - Fax:909-885-8244
Practice Address - Street 1:1849 COMMERCENTER E
Practice Address - Street 2:SUITE A
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3427
Practice Address - Country:US
Practice Address - Phone:909-884-4741
Practice Address - Fax:909-885-8244
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics