Healthcare Provider Details

I. General information

NPI: 1972941870
Provider Name (Legal Business Name): DAVID E THOME DDS PA I
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 MAHALEY AVE
SALISBURY NC
28144-2449
US

IV. Provider business mailing address

140 MAHALEY AVE
SALISBURY NC
28144-2449
US

V. Phone/Fax

Practice location:
  • Phone: 704-637-5506
  • Fax: 704-943-0593
Mailing address:
  • Phone: 704-637-5506
  • Fax: 704-943-0593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: REBEKAH MOORE TAYLOR
Title or Position: OFFICE MANAGER
Credential:
Phone: 704-604-0353