Provider Demographics
NPI:1205964905
Name:TON, THERESA P (DDS)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:P
Last Name:TON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4080 LAFAYETTE CENTER DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1247
Mailing Address - Country:US
Mailing Address - Phone:703-449-8572
Mailing Address - Fax:703-449-8572
Practice Address - Street 1:4080 LAFAYETTE CENTER DR
Practice Address - Street 2:SUITE 140
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1247
Practice Address - Country:US
Practice Address - Phone:703-449-8572
Practice Address - Fax:703-449-8572
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist