Provider Demographics
NPI:1922018407
Name:TOBIAN, MICHAEL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:TOBIAN
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 1:301 LENNON LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2483
Mailing Address - Country:US
Mailing Address - Phone:925-407-1155
Mailing Address - Fax:925-407-1161
Practice Address - Street 1:301 LENNON LN
Practice Address - Street 2:SUITE 102
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2483
Practice Address - Country:US
Practice Address - Phone:925-407-1155
Practice Address - Fax:925-407-1161
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist