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General NPI Number Information
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NPI Number | 1467092064
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Entity Type | Organization
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Legal Business Name | MATTHEW T. TOMODA DDS PC
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 9150 DICKEY DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2502
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Country | US
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Telephone | 540-292-7662
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Fax |
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Provider Business Mailing Address
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Address Line | 12057 HANOVER COURTHOUSE RD
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City | HANOVER
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State | VA
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Zip | 23069-1600
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Country | US
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Telephone | 540-292-7662
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW TOMODA
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Credential |
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Telephone | 540-292-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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