Provider Demographics
NPI:1487975678
Name:TOMASZEWSKI, LAURA FAHY (DDS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FAHY
Last Name:TOMASZEWSKI
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 1:6562 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2147
Mailing Address - Country:US
Mailing Address - Phone:985-789-0022
Mailing Address - Fax:985-641-5182
Practice Address - Street 1:2960 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4153
Practice Address - Country:US
Practice Address - Phone:985-641-7971
Practice Address - Fax:985-641-5182
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice