Provider Demographics
NPI:1689720104
Name:TSAUR, BENJAMIN (DDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:TSAUR
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 1:2021 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE C 101
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3391
Mailing Address - Country:US
Mailing Address - Phone:925-933-6092
Mailing Address - Fax:925-933-2159
Practice Address - Street 1:2021 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE C 101
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3391
Practice Address - Country:US
Practice Address - Phone:925-933-6092
Practice Address - Fax:925-933-2159
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA543121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice