Healthcare Provider Details

I. General information

NPI: 1124248745
Provider Name (Legal Business Name): GEORGE P. THOMAS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 DEVONSHIRE PL NW STE A
WASHINGTON DC
20008-3479
US

IV. Provider business mailing address

2737 DEVONSHIRE PL NW STE A
WASHINGTON DC
20008-3479
US

V. Phone/Fax

Practice location:
  • Phone: 202-232-1116
  • Fax: 202-232-1911
Mailing address:
  • Phone: 202-232-1116
  • Fax: 202-232-1911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN4058
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: