# TOSH FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548601776
- **Authorized official:** MICHAEL RORY TOSH DDS (OWNER/DENTIST)
- **Authorized official phone:** (765) 482-3201

## Contact information

- **Practice address:** 905 N LEBANON ST, LEBANON, IN 46052-1725
- **Practice address phone:** (765) 482-3201
- **Practice address fax:** (765) 482-3230
- **Mailing address:** 905 N LEBANON ST, LEBANON, IN 46052-1725
- **Mailing address phone:** (765) 482-3201
- **Mailing address fax:** (765) 482-3230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2013
- **Last updated:** 07/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1801863592 | — | IN |