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General NPI Number Information
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NPI Number | 1053449041
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Entity Type | Organization
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Legal Business Name | LAURIE JAYNE TOOMAJANIAN DDS PC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 339 N CENTER ST SUITE B.
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City | NORTHVILLE
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State | MI
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Zip | 48167-1288
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Country | US
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Telephone | 248-348-6780
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Fax | 248-348-0654
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Provider Business Mailing Address
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Address Line | 339 N CENTER ST SUITE B.
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City | NORTHVILLE
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State | MI
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Zip | 48167-1288
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Country | US
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Telephone | 248-348-6780
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Fax | 248-348-0654
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURIE JAYNE TOOMAJANIAN
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Credential | D.D.S.
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Telephone | 248-348-6780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901012564
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License Number State | MI
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