Provider Demographics
NPI:1649342676
Name:TOMSIK, JOHN S (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:TOMSIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 ROSE FARM RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2117
Mailing Address - Country:US
Mailing Address - Phone:228-875-6628
Mailing Address - Fax:228-875-8827
Practice Address - Street 1:6650 ROSE FARM RD
Practice Address - Street 2:SUITE A
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2117
Practice Address - Country:US
Practice Address - Phone:228-875-6628
Practice Address - Fax:228-875-8827
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1702751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice