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General NPI Number Information
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NPI Number | 1689600942
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Entity Type | Individual
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Provider Name | DR. TINOU T RONCONE
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Gender | Female
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 32140 US HIGHWAY 79 S STE. 201
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City | TEMECULA
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State | CA
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Zip | 92592-3899
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Country | US
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Telephone | 951-302-6385
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Fax |
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Provider Business Mailing Address
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Address Line | 31493 RANCHO PUEBLO RD STE. 101
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City | TEMECULA
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State | CA
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Zip | 92592-4832
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Country | US
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Telephone | 951-302-6385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 43567
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License Number State | CA
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