MEDICARE: MICHELLE TO, 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
1	1223P0221X	Pediatric Dentistry	46337	CA

General Provider Information

NPI Number	:	1972528958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE TO, DDS INC

Provider Business Mailing Address
First Line	:	151 S MEDNIK AVE
Second Line	:
City	:	EAST LOS ANGELES
State	:	CA
Zip	:	90022-1606
Country	:	US
Telephone Number	:	323-263-3303
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 S MEDNIK AVE
Second Line	:
City	:	EAST LOS ANGELES
State	:	CA
Zip	:	90022-1606
Country	:	US
Telephone Number	:	323-263-3303
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHELLE PUI HAN TO
Credential	:	DDS
Telephone Number	:	323-263-3303

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/14/2007

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