Healthcare Provider Details
I. General information
NPI: 1114882743
Provider Name (Legal Business Name): MICHAEL AND BRITTANY THOMAS DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4097 FULTON DR NW
CANTON OH
44718-2817
US
IV. Provider business mailing address
4097 FULTON DR NW
CANTON OH
44718-2817
US
V. Phone/Fax
- Phone: 614-580-5491
- Fax:
- Phone: 614-580-5491
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRITTANY
WOODARD
THOMAS
Title or Position: CO-OWNER
Credential: DDS
Phone: 614-580-5491