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NPI Code Detail

MEDICARE: DR. ROSEGEN TEJANO TOLENTINO DDS

MEDICARE: DR. ROSEGEN TEJANO TOLENTINO 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
1122300000XDentist42892CA

General Provider Information

NPI Number : 1972667566
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSEGEN TEJANO TOLENTINO DDS
Provider Business Mailing Address
First Line : 2777 PACIFIC AVE STE M
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2627
Country : US
Telephone Number : 562-426-9390
Fax Number : 562-426-9589
Provider Business Practice Location Address
First Line : 2777 PACIFIC AVE STE M
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2627
Country : US
Telephone Number : 562-426-9390
Fax Number : 562-426-9589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/08/2007

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