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General NPI Number Information
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NPI Number | 1346814316
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Entity Type | Individual
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Provider Name | JONATHAN CHASE TOLAND DDS
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Gender | Male
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 40470 GERMANY RD
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City | GONZALES
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State | LA
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Zip | 70737-6735
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Country | US
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Telephone | 225-622-2022
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 FOCIS ST
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City | METAIRIE
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State | LA
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Zip | 70005-2220
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Country | US
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Telephone | 318-780-2824
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7225
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License Number State | LA
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