Healthcare Provider Details

I. General information

NPI: 1003727256
Provider Name (Legal Business Name): THOMAS DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 NW 10TH AVE STE 400
BOCA RATON FL
33486-1339
US

IV. Provider business mailing address

1590 NW 10TH AVE STE 400
BOCA RATON FL
33486-1339
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-9966
  • Fax:
Mailing address:
  • Phone: 561-368-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHASE THOMAS
Title or Position: OWNER
Credential: DMD
Phone: 954-218-9196