Provider Demographics
NPI:1780606699
Name:TOMASELLI, CLAUDIA (DMD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:
Last Name:TOMASELLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 PARKWAY 575
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-6439
Mailing Address - Country:US
Mailing Address - Phone:770-924-0424
Mailing Address - Fax:
Practice Address - Street 1:375 PARKWAY 575
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6439
Practice Address - Country:US
Practice Address - Phone:770-924-0424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry