Provider Demographics
NPI:1720311905
Name:MATTHEW TOMALA DDS MSD PLLC
Entity Type:Organization
Organization Name:MATTHEW TOMALA DDS MSD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:TOMALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:206-402-5147
Mailing Address - Street 1:207 SW 156TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2561
Mailing Address - Country:US
Mailing Address - Phone:206-402-5147
Mailing Address - Fax:206-402-5172
Practice Address - Street 1:207 SW 156TH ST STE 2
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2561
Practice Address - Country:US
Practice Address - Phone:206-402-5147
Practice Address - Fax:206-402-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-07
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000107741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty