Provider Demographics
NPI:1912544370
Name:TINOU T. RONCONE, DDS, MS, APC
Entity Type:Organization
Organization Name:TINOU T. RONCONE, DDS, MS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TINOU
Authorized Official - Middle Name:
Authorized Official - Last Name:RONCONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:951-302-6385
Mailing Address - Street 1:31493 RANCHO PUEBLO RD.
Mailing Address - Street 2:STE. 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-302-6385
Mailing Address - Fax:
Practice Address - Street 1:31493 RANCHO PUEBLO RD.
Practice Address - Street 2:STE. 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-302-6385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TINOU T. RONCONE, DDS, MS, APC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty