Provider Demographics
NPI:1932111838
Name:TOCHE, DIANA LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:TOCHE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:TOCHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14054 KILLARNEY DR
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-9506
Mailing Address - Country:US
Mailing Address - Phone:559-392-7845
Mailing Address - Fax:
Practice Address - Street 1:20 N DEWITT AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0311
Practice Address - Country:US
Practice Address - Phone:559-299-2570
Practice Address - Fax:559-299-2391
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377461223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD37746Medicaid