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General NPI Number Information
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NPI Number | 1538328315
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Entity Type | Organization
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Legal Business Name | JAMES TO I DMD PS
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 120 AVENUE A STE A
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City | SNOHOMISH
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State | WA
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Zip | 98290-2961
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Country | US
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Telephone | 360-568-8581
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Fax |
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Provider Business Mailing Address
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Address Line | 120 AVENUE A STE A
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City | SNOHOMISH
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State | WA
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Zip | 98290-2961
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Country | US
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Telephone | 360-568-8581
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Fax |
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Authorized Official
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Title or Position | PERSIDENT
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Name | JAMES TO
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Credential | DMD
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Telephone | 360-568-8581
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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 | 9165
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License Number State | WA
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