Provider Demographics
NPI:1144708512
Name:SZABO, TONI LEIGH
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:LEIGH
Last Name:SZABO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 CARRIGAN CT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-4224
Mailing Address - Country:US
Mailing Address - Phone:574-243-9383
Mailing Address - Fax:
Practice Address - Street 1:14700 CARRIGAN CT
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-4224
Practice Address - Country:US
Practice Address - Phone:574-243-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-29
Last Update Date:2018-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13003657124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist