Provider Demographics
NPI:1326264086
Name:TOTH, AGNIESZKA BEATA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AGNIESZKA
Middle Name:BEATA
Last Name:TOTH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AGNIESZKA
Other - Middle Name:BEATA
Other - Last Name:GOOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:84 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644
Mailing Address - Country:US
Mailing Address - Phone:973-650-1695
Mailing Address - Fax:
Practice Address - Street 1:21 MARKET STR
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501
Practice Address - Country:US
Practice Address - Phone:973-754-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053843-11223P0221X
NJ22DI023045001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry