Provider Demographics
NPI:1982852737
Name:IMLER, TOBY J (DDS)
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:J
Last Name:IMLER
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:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:AMITY
Mailing Address - State:AR
Mailing Address - Zip Code:71921
Mailing Address - Country:US
Mailing Address - Phone:870-342-5265
Mailing Address - Fax:
Practice Address - Street 1:439 E. THOMPSON ST
Practice Address - Street 2:
Practice Address - City:AMITY
Practice Address - State:AR
Practice Address - Zip Code:71921
Practice Address - Country:US
Practice Address - Phone:870-342-5265
Practice Address - Fax:870-342-6292
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist