Provider Demographics
NPI:1730675109
Name:HEALING PROPERTY LLC
Entity Type:Organization
Organization Name:HEALING PROPERTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANZIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-298-5959
Mailing Address - Street 1:2211 MOORPARK AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2655
Mailing Address - Country:US
Mailing Address - Phone:408-298-5959
Mailing Address - Fax:408-927-5085
Practice Address - Street 1:2211 MOORPARK AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2655
Practice Address - Country:US
Practice Address - Phone:408-298-5959
Practice Address - Fax:408-927-5085
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUCIA TANZIL DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40740261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental