Provider Demographics
NPI:1801039284
Name:P. TIEMPETPAISAL DDS INC
Entity Type:Organization
Organization Name:P. TIEMPETPAISAL DDS INC
Other - Org Name:SOFT CARE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PANADDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIEMPETPAISAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-963-4297
Mailing Address - Street 1:199 OLDENBURG LN
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3953
Mailing Address - Country:US
Mailing Address - Phone:951-963-4297
Mailing Address - Fax:
Practice Address - Street 1:910 WASHBURN AVE
Practice Address - Street 2:SUITE D
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4383
Practice Address - Country:US
Practice Address - Phone:951-963-4297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty