Provider Demographics
NPI:1063635100
Name:TOMKO, LORRI ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LORRI
Middle Name:ANN
Last Name:TOMKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LORRI
Other - Middle Name:ANN
Other - Last Name:BURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7525 TILGHMAN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9016
Mailing Address - Country:US
Mailing Address - Phone:610-395-4195
Mailing Address - Fax:610-395-1972
Practice Address - Street 1:7525 TILGHMAN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9016
Practice Address - Country:US
Practice Address - Phone:610-395-4195
Practice Address - Fax:610-395-1972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026752L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice