Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 39286 | NY |
Y | 1223D0001X | Dental Public Health | 8817 | TN |
NPI | 1053571927 |
---|---|
Provider Name | Dr. Carl Michael Todoro |
First Address | Knoxville, TN 37917-6413 |
Second Address | Knoxville, TN 37917-6413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 19/04/2011 |