Provider Demographics
NPI:1730300567
Name:TOTTORI, LAWRENCE TSUNEMICHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:TSUNEMICHI
Last Name:TOTTORI
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 1:2180 STORY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1608
Mailing Address - Country:US
Mailing Address - Phone:408-923-5297
Mailing Address - Fax:408-251-6077
Practice Address - Street 1:2180 STORY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1608
Practice Address - Country:US
Practice Address - Phone:408-923-5297
Practice Address - Fax:408-251-6077
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist