Provider Demographics
NPI:1154534881
Name:TOLIA, KIRTI J (DDS)
Entity type:Individual
Prefix:
First Name:KIRTI
Middle Name:J
Last Name:TOLIA
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 1:271 US HIGHWAY 46 WEST
Mailing Address - Street 2:SUITE#A-207
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004
Mailing Address - Country:US
Mailing Address - Phone:973-276-9202
Mailing Address - Fax:973-276-9112
Practice Address - Street 1:271 US HIGHWAY 46 WEST
Practice Address - Street 2:SUITE#A-207
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004
Practice Address - Country:US
Practice Address - Phone:973-276-9202
Practice Address - Fax:973-276-9112
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 017230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist