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General NPI Number Information
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NPI Number | 1154741940
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Entity Type | Organization
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Legal Business Name | THOMAS S. HOM DMDPC
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 185 PARK ROW STE 9
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City | NEW YORK
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State | NY
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Zip | 10038-5000
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Country | US
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Telephone | 212-732-1329
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Fax |
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Provider Business Mailing Address
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Address Line | 185 PARK ROW STE 9
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City | NEW YORK
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State | NY
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Zip | 10038-5000
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Country | US
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Telephone | 212-732-1329
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. THOMAS SHELWAH HOM
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Credential | D.M.D.
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Telephone | 212-732-1329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 032253
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License Number State | NY
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