Provider Demographics
NPI:1861126138
Name:MICHAEL T. TOBOLA DDS,PC
Entity type:Organization
Organization Name:MICHAEL T. TOBOLA DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:TOBOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:248-852-8766
Mailing Address - Street 1:3709 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3324
Mailing Address - Country:US
Mailing Address - Phone:248-852-8766
Mailing Address - Fax:
Practice Address - Street 1:3709 AUBURN RD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3324
Practice Address - Country:US
Practice Address - Phone:248-852-8766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental