Provider Demographics
NPI:1194746610
Name:CLAUDIA E. TOMASELLI, D.M.D., P.C.
Entity type:Organization
Organization Name:CLAUDIA E. TOMASELLI, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMASELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-924-0424
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:770-592-0636
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:770-592-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty