Individual
DR. BEN F TARSITANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
70 PENNY LN, SUITE B, WATSONVILLE, CA 95076-6020
(831) 722-8887
(831) 722-2762
Mailing address
70 PENNY LN, SUITE B, WATSONVILLE, CA 95076-6020
(831) 722-8887
(831) 722-2762
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
28822
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A50488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A504880
—
CA
Enumeration date
01/24/2007
Last updated
12/11/2013
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