Provider Demographics
NPI:1528677879
Name:TOMAYKO, ADAM (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:TOMAYKO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-9032
Mailing Address - Country:US
Mailing Address - Phone:724-549-6336
Mailing Address - Fax:
Practice Address - Street 1:116 6TH ST
Practice Address - Street 2:
Practice Address - City:CLYMER
Practice Address - State:PA
Practice Address - Zip Code:15728-1189
Practice Address - Country:US
Practice Address - Phone:724-254-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist