Provider Demographics
NPI:1750524500
Name:DAVID TOMA DDS, INC.
Entity type:Organization
Organization Name:DAVID TOMA DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-964-0750
Mailing Address - Street 1:645 SWEETWATER RD.
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977
Mailing Address - Country:US
Mailing Address - Phone:619-464-0426
Mailing Address - Fax:866-566-8288
Practice Address - Street 1:418 E. GLENOAKS BLVD. SUITE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-2014
Practice Address - Country:US
Practice Address - Phone:866-549-1171
Practice Address - Fax:866-566-8288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID TOMA DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-09
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty