Healthcare Provider Details

I. General information

NPI: 1710500921
Provider Name (Legal Business Name): JAMES P THOMAS JR. DDS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 W TIENKEN RD
ROCHESTER HILLS MI
48306-4475
US

IV. Provider business mailing address

640 TIMBERLINE DR
ROCHESTER HILLS MI
48309-1313
US

V. Phone/Fax

Practice location:
  • Phone: 248-652-7770
  • Fax:
Mailing address:
  • Phone: 248-321-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA THOMAS
Title or Position: MANAGER
Credential: BA, MS
Phone: 248-321-1625