Provider Demographics
NPI:1760569685
Name:SANTOS-TOMAS, CRISTINA LOURO (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:LOURO
Last Name:SANTOS-TOMAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 OLDE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4821
Mailing Address - Country:US
Mailing Address - Phone:860-793-7117
Mailing Address - Fax:
Practice Address - Street 1:435 WILLARD AVE UNIT C
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2318
Practice Address - Country:US
Practice Address - Phone:860-372-4600
Practice Address - Fax:860-372-4602
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT94091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry