Organization Name: | THOMAS T. OMOTO DMD & STEVEN D. BARNEY DDS, INC |
NPI Number: | 1255357893 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS TERUMI OMTOT (PRESIDENT) |
Mailing Address: | 927 Deep Valley Dr Suite 130 Rolling Hills Estates |
State: | CA US |
Postal Code: | 902743808 |
Phone Number: | 3103770929 |
Fax Number: | 3103770794 |
NPI Enumeration Date: | 07/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 31506 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |