Provider Demographics
NPI:1033237466
Name:HART, TOSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOSHI
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 DALE RD
Mailing Address - Street 2:SUITE B-6
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8505
Mailing Address - Country:US
Mailing Address - Phone:209-543-6937
Mailing Address - Fax:209-543-6615
Practice Address - Street 1:4213 DALE RD
Practice Address - Street 2:SUITE B-6
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8505
Practice Address - Country:US
Practice Address - Phone:209-543-6937
Practice Address - Fax:209-543-6615
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice