Provider Demographics
NPI:1154459139
Name:TOOMAJANIAN, LAURIE JAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:JAYNE
Last Name:TOOMAJANIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 N CENTER ST
Mailing Address - Street 2:SUITE B.
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1288
Mailing Address - Country:US
Mailing Address - Phone:248-348-6780
Mailing Address - Fax:248-348-0654
Practice Address - Street 1:339 N CENTER ST
Practice Address - Street 2:SUITE B.
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1288
Practice Address - Country:US
Practice Address - Phone:248-348-6780
Practice Address - Fax:248-348-0654
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010125641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice