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General NPI Number Information
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NPI Number | 1215127477
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Entity Type | Organization
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Legal Business Name | WILLIAM G TIN DDS INC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 1498 N VASCO ROAD
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City | LIVERMORE
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State | CA
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Zip | 94551-9213
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Country | US
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Telephone | 925-454-1132
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Fax | 925-454-1135
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Provider Business Mailing Address
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Address Line | 1498 N VASCO ROAD
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City | LIVERMORE
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State | CA
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Zip | 94551-9213
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Country | US
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Telephone | 925-454-1132
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Fax | 925-454-1135
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Authorized Official
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Title or Position | PRESIDENT DENTIST
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Name | MR. WILLIAM GABIANA TIU
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Credential | DDS
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Telephone | 925-454-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 43083
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License Number State | CA
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