Provider Demographics
NPI:1053449041
Name:LAURIE JAYNE TOOMAJANIAN DDS PC
Entity Type:Organization
Organization Name:LAURIE JAYNE TOOMAJANIAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:TOOMAJANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-348-6780
Mailing Address - Street 1:339 N CENTER ST
Mailing Address - Street 2:SUITE B.
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1288
Mailing Address - Country:US
Mailing Address - Phone:248-348-6780
Mailing Address - Fax:248-348-0654
Practice Address - Street 1:339 N CENTER ST
Practice Address - Street 2:SUITE B.
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1288
Practice Address - Country:US
Practice Address - Phone:248-348-6780
Practice Address - Fax:248-348-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010125641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty