Provider Demographics
NPI:1619053840
Name:SAUZ, JOSE TOLENTINO (DMD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:TOLENTINO
Last Name:SAUZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2204
Mailing Address - Country:US
Mailing Address - Phone:213-483-8754
Mailing Address - Fax:213-483-8755
Practice Address - Street 1:2116 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2204
Practice Address - Country:US
Practice Address - Phone:213-483-8754
Practice Address - Fax:213-483-8755
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice