Provider Demographics
NPI:1023409752
Name:CYNTHIA TUASON DDS INC
Entity type:Organization
Organization Name:CYNTHIA TUASON DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUASON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-863-0836
Mailing Address - Street 1:1061 SATURN BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-2051
Mailing Address - Country:US
Mailing Address - Phone:619-863-0836
Mailing Address - Fax:619-863-0893
Practice Address - Street 1:1061 SATURN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-2051
Practice Address - Country:US
Practice Address - Phone:619-863-0836
Practice Address - Fax:619-863-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46440261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1164611471OtherNPPES