Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0401008199 | VA |
NPI | 1154591261 |
---|---|
Provider Name | Dr. Richard William Toth |
First Address | Fairfax, VA 22030-3133 |
Second Address | Fairfax, VA 22030-3133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |