Provider Demographics
NPI:1750557120
Name:FRED S. TSUTSUI DMD, INC.
Entity type:Organization
Organization Name:FRED S. TSUTSUI DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:S
Authorized Official - Last Name:TSUTSUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:310-791-1790
Mailing Address - Street 1:3640 LOMITA BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3957
Mailing Address - Country:US
Mailing Address - Phone:310-791-1790
Mailing Address - Fax:310-791-1062
Practice Address - Street 1:3640 LOMITA BLVD STE 304
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3957
Practice Address - Country:US
Practice Address - Phone:310-791-1790
Practice Address - Fax:310-791-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty