Provider Demographics
NPI:1780674911
Name:TSURUDA, DEANNA MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:TSURUDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 LIVE OAK BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-671-3111
Mailing Address - Fax:
Practice Address - Street 1:1408 LIVE OAK BLVD
Practice Address - Street 2:STE D
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-671-3111
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist