Healthcare Provider Details

I. General information

NPI: 1184649295
Provider Name (Legal Business Name): THOMAS JOSEPH TOFFOLI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 CROW CANYON RD STE 215
SAN RAMON CA
94583-1583
US

IV. Provider business mailing address

2723 CROW CANYON RD STE 215
SAN RAMON CA
94583-1583
US

V. Phone/Fax

Practice location:
  • Phone: 925-838-1533
  • Fax: 925-838-3146
Mailing address:
  • Phone: 925-838-1533
  • Fax: 925-838-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: