Provider Demographics
NPI:1477605970
Name:TOLOSA, JOSE JAVIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JAVIER
Last Name:TOLOSA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B7 CALLE SANTA ISABEL
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5417
Mailing Address - Country:US
Mailing Address - Phone:787-764-6670
Mailing Address - Fax:
Practice Address - Street 1:9410 LOS ROMERO AVE. SUITE 207
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-790-2420
Practice Address - Fax:787-790-2455
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics