Provider Demographics
NPI:1750448171
Name:TOVAR, VERONICA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:TOVAR
Suffix:
Gender:F
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:W6179 NEUBERT RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7988
Mailing Address - Country:US
Mailing Address - Phone:920-757-9440
Mailing Address - Fax:920-757-9390
Practice Address - Street 1:W6179 NEUBERT RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7988
Practice Address - Country:US
Practice Address - Phone:920-757-9440
Practice Address - Fax:920-757-9390
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1609021237OtherBUSINESS NPI