Provider Demographics
NPI:1356495139
Name:TOGNOTTI, MATTHEW VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:VINCENT
Last Name:TOGNOTTI
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 1:1844 SAN MIGUEL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8601
Mailing Address - Country:US
Mailing Address - Phone:925-934-2066
Mailing Address - Fax:925-932-0124
Practice Address - Street 1:1844 SAN MIGUEL DR STE 102
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8601
Practice Address - Country:US
Practice Address - Phone:925-934-2066
Practice Address - Fax:925-932-0124
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice