Provider Demographics
NPI:1578733564
Name:TOLIA, MAHENDRA DAHYALAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHENDRA
Middle Name:DAHYALAL
Last Name:TOLIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:MAHENDRA
Other - Middle Name:DAHYALAL
Other - Last Name:TOLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:417 DUNDEE AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3830
Mailing Address - Country:US
Mailing Address - Phone:847-608-7910
Mailing Address - Fax:847-608-7910
Practice Address - Street 1:417 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3830
Practice Address - Country:US
Practice Address - Phone:847-608-7910
Practice Address - Fax:847-608-7910
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice