MEDICARE: DR. THOMAS W S PUZIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	27056	CA

General Provider Information

NPI Number	:	1083750657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS W S PUZIN DDS

Provider Business Mailing Address
First Line	:	545 SARATOGA AV
Second Line	:	THOMAS PUZIN DDS FAMILY DENTISTRY SUITE B
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-5672
Country	:	US
Telephone Number	:	408-247-5442
Fax Number	:	408-247-9412

Provider Business Practice Location Address
First Line	:	545 SARATOGA AV
Second Line	:	SUITE B
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-5672
Country	:	US
Telephone Number	:	408-247-5442
Fax Number	:	408-247-9412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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