Provider Demographics
NPI:1457431124
Name:TOMASINO, CESAR E (DDS)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:E
Last Name:TOMASINO
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 1:338 NORTHAVEN DR.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3649
Mailing Address - Country:US
Mailing Address - Phone:210-436-0850
Mailing Address - Fax:210-436-0729
Practice Address - Street 1:338 NORTHAVEN DR.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3649
Practice Address - Country:US
Practice Address - Phone:210-436-0850
Practice Address - Fax:210-436-0729
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130712605Medicaid