Provider Demographics
NPI:1114291846
Name:TOSO, LYDIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:TOSO
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 1:1502 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-6136
Mailing Address - Country:US
Mailing Address - Phone:504-899-8383
Mailing Address - Fax:504-899-8384
Practice Address - Street 1:1502 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-6136
Practice Address - Country:US
Practice Address - Phone:504-899-8383
Practice Address - Fax:504-899-8384
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics