MEDICARE: DR. THOMAS MICHAEL TOUHEY D.D.S

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	1223G0001X	General Practice Dentistry	30.024997	OH
3	122300000X	Dentist	2007032184	MO

General Provider Information

NPI Number	:	1700036456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS MICHAEL TOUHEY D.D.S

Provider Business Mailing Address
First Line	:	20390 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-895-1627
Fax Number	:	440-895-1635

Provider Business Practice Location Address
First Line	:	20390 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-895-1627
Fax Number	:	440-895-1635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	02/11/2019

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