Provider Demographics
NPI:1821184698
Name:TOMASE, TIMOTHY (DDS)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:TOMASE
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 1:3030 W SYLVANIA
Mailing Address - Street 2:STE 104
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613
Mailing Address - Country:US
Mailing Address - Phone:419-474-5858
Mailing Address - Fax:419-474-5818
Practice Address - Street 1:3030 W SYLVANIA
Practice Address - Street 2:STE 104
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613
Practice Address - Country:US
Practice Address - Phone:419-474-5858
Practice Address - Fax:419-474-5818
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH018333332B00000X
OH30018333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies