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NPI Code Detail

MEDICARE: CYNTHIA DIANE TOTTLE D.D.S.

MEDICARE:   CYNTHIA DIANE TOTTLE  D.D.S.
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
11223G0001XGeneral Practice Dentistry39236CA

General Provider Information

NPI Number : 1992081061
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA DIANE TOTTLE D.D.S.
Provider Business Mailing Address
First Line : 878 PALISADE DR
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-3527
Country : US
Telephone Number : 510-703-0581
Fax Number :
Provider Business Practice Location Address
First Line : 1494 WASHINGTON BLVD
Second Line : SUITE C
City : CONCORD
State : CA
Zip : 94521-4064
Country : US
Telephone Number : 925-672-0150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2011
Last Update Date : 11/02/2011

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Directions to “ CYNTHIA DIANE TOTTLE D.D.S.” Practice Location

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