Provider Demographics
NPI:1720102718
Name:TINLOY, DOUGLAS BRUCE (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BRUCE
Last Name:TINLOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 VAN NESS AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3023
Mailing Address - Country:US
Mailing Address - Phone:415-441-1246
Mailing Address - Fax:415-441-1247
Practice Address - Street 1:2000 VAN NESS AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3023
Practice Address - Country:US
Practice Address - Phone:415-441-1246
Practice Address - Fax:415-441-1247
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics