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General NPI Number Information
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NPI Number | 1043956519
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Entity Type | Individual
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Provider Name | ANTOINE THOMAS
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Gender | Male
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 275 W MAIN ST
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City | NORTON
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State | MA
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Zip | 02766-2104
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Country | US
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Telephone | 508-226-1686
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Fax |
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Provider Business Mailing Address
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Address Line | 601 SALISBURY ST
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City | WORCESTER
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State | MA
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Zip | 01609-1327
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Country | US
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Telephone | 508-769-0447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859686
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1859686
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License Number State | MA
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