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NPI Code Detail

MEDICARE: TOMA & PETROS DDS INC

MEDICARE: TOMA & PETROS DDS INC
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
1122300000XDentist48043CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D48043OTHERCADENTICAL

General Provider Information

NPI Number : 1902967383
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOMA & PETROS DDS INC
Provider Business Mailing Address
First Line : 3530 CAMINO DEL RIO NORTH
Second Line : SUITE 109
City : SAN DIEGO
State : CA
Zip : 92108
Country : US
Telephone Number : 619-283-2093
Fax Number : 619-283-0803
Provider Business Practice Location Address
First Line : 3530 CAMINO DEL RIO NORTH
Second Line : SUITE 109
City : SAN DIEGO
State : CA
Zip : 92108
Country : US
Telephone Number : 619-283-2093
Fax Number : 619-283-0803
Authorized Official
Title or Position : ASSOCIATE DENTIST PARTNER
Name : DR. OMEED BUTRUS TOMA
Credential : DDS
Telephone Number : 619-283-2093
Provider Enumeration Date : 12/12/2006
Last Update Date : 08/22/2020

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Directions to “TOMA & PETROS DDS INC ” Practice Location

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