Healthcare Provider Details

I. General information

NPI: 1851436604
Provider Name (Legal Business Name): THOMAS A. TOHILL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SARAHS LN
SOMERSET KY
42503-2775
US

IV. Provider business mailing address

101 SARAHS LN
SOMERSET KY
42503-2775
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-4450
  • Fax: 606-677-1418
Mailing address:
  • Phone: 606-679-4450
  • Fax: 606-677-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4764
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: