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General NPI Number Information
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NPI Number | 1770980856
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Entity Type | Organization
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Legal Business Name | ANITA TOMKORIA, A DENTAL CORPORATION
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 27462 CALLE ARROYO SUITE B
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675
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Country | US
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Telephone | 949-443-9533
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Fax |
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Provider Business Mailing Address
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Address Line | 27462 CALLE ARROYO SUITE B
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675
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Country | US
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Telephone | 949-443-9533
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Fax |
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Authorized Official
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Title or Position | ENDODONTIST
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Name | DR. ANITA KUMARI TOMKORIA
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Credential | DDS
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Telephone | 949-443-9533
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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