MEDICARE: THOMAS M FUCHS DMD

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
1	1223G0001X	General Practice Dentistry	6032	KY

General Provider Information

NPI Number	:	1821169061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M FUCHS DMD

Provider Business Mailing Address
First Line	:	10907 TALON WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-5579
Country	:	US
Telephone Number	:	502-253-0260
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 MIDDLETOWN PARK PL
Second Line	:	SUITE A
City	:	LOUISVILLE
State	:	KY
Zip	:	40243-2514
Country	:	US
Telephone Number	:	502-253-0008
Fax Number	:	502-253-0039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	07/08/2007

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