Healthcare Provider Details

I. General information

NPI: 1306098694
Provider Name (Legal Business Name): MARIA ISABELLE SANTOS TUOHY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5270 NEWPARK PLAZA
NEWARK CA
94560
US

IV. Provider business mailing address

5270 NEWPARK PLAZA
NEWARK CA
94560
US

V. Phone/Fax

Practice location:
  • Phone: 510-791-8118
  • Fax: 510-797-8881
Mailing address:
  • Phone: 510-791-8118
  • Fax: 510-797-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number57550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: