Glen A. Tistaert in Santa Monica - General Practice
Glen A. Tistaert - NPI 1184841207
Glen A. Tistaert is a General Practice in Santa Monica, California. Glen A. Tistaert practices all healthcare services and medical treatments related to General Practice. The NPI Number for Glen A. Tistaert is 1184841207. The last update date is 2007-07-08.
Glen A. Tistaert's current location address is 2648 34th St, Santa Monica, California. You can contact this provider via phone number 3103942661 and fax number 3104518971. The mailing address for Glen A. Tistaert is 2648 34th St, Santa Monica, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glen A. Tistaert |
|---|---|
| Address | 2648 34th St, Santa Monica, California |
| Phone Number | 3103942661 |
| Fax Number | 3104518971 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1184841207 |
|---|---|
| Provider Enumeration Date | 2007-04-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2648 34th St |
|---|---|
| City | Santa Monica |
| State | California (CA) |
| Post Code | 904053115 |
| Phone Number | 3103942661 |
| Fax Number | 3104518971 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 18421 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the Glen A. Tistaert's unique identification number?
The Glen A. Tistaert has been assigned the NPI (National Provider Identifier) Number 1184841207 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Glen A. Tistaert is physically located?
The Glen A. Tistaert is physically situated at the following address: 2648 34Th St, Santa Monica, CA, 904053115.
What is Glen A. Tistaert's area of expertise and its corresponding taxonomy classification?
The Glen A. Tistaert's field of specialization is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their areas of practice.
When did Glen A. Tistaert receive its 1184841207 assignment?
The Glen A. Tistaert was assigned its 1184841207 on 2007-04-19, which is the date when this unique identifier was issued to the organization.
As of what date were the Glen A. Tistaert's details last updated?
The information pertaining to the Glen A. Tistaert, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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