Provider Demographics
NPI:1548667850
Name:GASIOR, EVA (DDS)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:GASIOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 WHISPERING WIND DR
Mailing Address - Street 2:SUITE102
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 WHISPERING WIND DR
Practice Address - Street 2:SUITE102
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-8119
Practice Address - Country:US
Practice Address - Phone:209-830-7032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist