Provider Demographics
NPI:1922210590
Name:TUAZON D.D.S. CORPORATION
Entity Type:Organization
Organization Name:TUAZON D.D.S. CORPORATION
Other - Org Name:VACAVILLE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANILO
Authorized Official - Middle Name:LISING
Authorized Official - Last Name:TUAZON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:707-451-4100
Mailing Address - Street 1:2010C HARBISON DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3900
Mailing Address - Country:US
Mailing Address - Phone:707-451-4100
Mailing Address - Fax:707-451-4963
Practice Address - Street 1:2010C HARBISON DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3900
Practice Address - Country:US
Practice Address - Phone:707-451-4100
Practice Address - Fax:707-451-4963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49690122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty