Healthcare Provider Details

I. General information

NPI: 1245907690
Provider Name (Legal Business Name): BRITTANY W THOMAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WALES AVE NW STE B
MASSILLON OH
44646-2366
US

IV. Provider business mailing address

520 E MAIN ST
LOUISVILLE OH
44641-1472
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-2619
  • Fax:
Mailing address:
  • Phone: 614-580-5491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30026636
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: