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General NPI Number Information
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NPI Number | 1104248293
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Entity Type | Organization
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Legal Business Name | THOMAS F GESSEL PLLC
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 1628 S MILDRED ST STE 201
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City | TACOMA
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State | WA
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Zip | 98465-1629
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Country | US
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Telephone | 253-503-1023
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Fax | 253-448-2995
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Provider Business Mailing Address
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Address Line | 1628 S MILDRED ST STE 201
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City | TACOMA
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State | WA
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Zip | 98465-1629
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Country | US
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Telephone | 253-503-1023
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Fax | 253-448-2995
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS FREDERICK GESSEL
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Credential | DMD
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Telephone | 253-503-1023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE 60175336
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License Number State | WA
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