MEDICARE: NATALIA TOMONA D.D.S. PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	13290	MD

General Provider Information

NPI Number	:	1538370671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIA TOMONA D.D.S. PC

Provider Business Mailing Address
First Line	:	12850 MIDDLEBROOK RD
Second Line	:	SUITE 102
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-5244
Country	:	US
Telephone Number	:	301-540-6301
Fax Number	:	301-540-6302

Provider Business Practice Location Address
First Line	:	12850 MIDDLEBROOK RD
Second Line	:	SUITE 102
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-5244
Country	:	US
Telephone Number	:	301-540-6301
Fax Number	:	301-540-6302

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NATALIA TOMONA
Credential	:	D.D.S
Telephone Number	:	301-540-6301

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	04/16/2024

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