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General NPI Number Information
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NPI Number | 1114815693
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Entity Type | Individual
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Provider Name | AMBER THOMAS
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 440 WESTHAVEN CT
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City | GROVETOWN
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State | GA
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Zip | 30813-0760
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Country | US
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Telephone | 706-619-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 3507 PRESTON TRL
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City | MARTINEZ
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State | GA
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Zip | 30907-9505
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Country | US
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Telephone | 903-269-8899
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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 | DN123812
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License Number State | GA
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