MEDICARE: JULIE MARIE THOMAS D.D.S.

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	19511	OH

General Provider Information

NPI Number	:	1841232998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MARIE THOMAS D.D.S.

Provider Business Mailing Address
First Line	:	1437 S MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4245
Country	:	US
Telephone Number	:	330-244-9081
Fax Number	:	330-244-8885

Provider Business Practice Location Address
First Line	:	1437 S MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4245
Country	:	US
Telephone Number	:	330-244-9081
Fax Number	:	330-244-8885

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/26/2022

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