Provider Demographics
NPI:1215127477
Name:WILLIAM G TIN DDS INC
Entity type:Organization
Organization Name:WILLIAM G TIN DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GABIANA
Authorized Official - Last Name:TIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-454-1132
Mailing Address - Street 1:1498 N VASCO ROAD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-9213
Mailing Address - Country:US
Mailing Address - Phone:925-454-1132
Mailing Address - Fax:925-454-1135
Practice Address - Street 1:1498 N VASCO ROAD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-9213
Practice Address - Country:US
Practice Address - Phone:925-454-1132
Practice Address - Fax:925-454-1135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM G TIN DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty