Provider Demographics
NPI:1275799561
Name:TOSI, JOHN D (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:TOSI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5628 MURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3876
Mailing Address - Country:US
Mailing Address - Phone:901-761-2550
Mailing Address - Fax:901-761-2551
Practice Address - Street 1:5628 MURRAY RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3876
Practice Address - Country:US
Practice Address - Phone:901-761-2550
Practice Address - Fax:901-761-2551
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS7032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist