Provider Demographics
NPI:1447709241
Name:MARIO A. TOMEI DDS PC
Entity type:Organization
Organization Name:MARIO A. TOMEI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOMEI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:734-261-7555
Mailing Address - Street 1:32300 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4308
Mailing Address - Country:US
Mailing Address - Phone:734-261-7555
Mailing Address - Fax:734-261-9319
Practice Address - Street 1:32300 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4308
Practice Address - Country:US
Practice Address - Phone:734-261-7555
Practice Address - Fax:734-261-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty