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NPI Code Detail

MEDICARE: THOMAS DDS PERIODONTAL SPECIALISTS

MEDICARE: THOMAS DDS PERIODONTAL SPECIALISTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center015600KS

General Provider Information

NPI Number : 1447420526
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS DDS PERIODONTAL SPECIALISTS
Provider Business Mailing Address
First Line : 209 NE BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-2721
Country : US
Telephone Number : 816-436-6767
Fax Number : 816-436-6766
Provider Business Practice Location Address
First Line : 209 NE BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-2721
Country : US
Telephone Number : 816-436-6767
Fax Number : 816-436-6766
Authorized Official
Title or Position : PERIODONTIST
Name : DANIEL THOMAS
Credential : DDS
Telephone Number : 816-436-6767
Provider Enumeration Date : 03/05/2008
Last Update Date : 03/05/2008

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