Provider Demographics
NPI:1144310228
Name:TINUCCI, RAYMOND FAUST (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:FAUST
Last Name:TINUCCI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5728
Mailing Address - Country:US
Mailing Address - Phone:610-326-8770
Mailing Address - Fax:610-326-3935
Practice Address - Street 1:703 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5728
Practice Address - Country:US
Practice Address - Phone:610-326-8770
Practice Address - Fax:610-326-3935
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026354L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice