Organization
M.S. TANCIO, D.M.D. A PROFESSIONAL DENTAL CORPORATION
Active
Other names
Civic Center Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL TANCIO DMD (DENTIST/OWNER)
(510) 793-5033
Entity
Organization
Contact information
Practice address
39370 CIVIC CENTER DR, SUITE D, FREMONT, CA 94538-6716
(510) 793-5033
(510) 793-5133
Mailing address
39370 CIVIC CENTER DR, SUITE D, FREMONT, CA 94538-6716
(510) 793-5033
(510) 793-5133
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
40889
CA
Other
Enumeration date
02/21/2008
Last updated
02/21/2008
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