Provider Demographics
NPI:1760566590
Name:TUFAROLO, JEFFREY J (DDS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:TUFAROLO
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 1:3624 COLBY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4789
Mailing Address - Country:US
Mailing Address - Phone:425-258-2834
Mailing Address - Fax:
Practice Address - Street 1:3624 COLBY AVE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4789
Practice Address - Country:US
Practice Address - Phone:425-258-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA52031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice