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General NPI Number Information
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NPI Number | 1184579427
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Entity Type | Organization
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Legal Business Name | THOMAS J GRASS DMD LLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1621 TONGASS AVE STE 301
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City | KETCHIKAN
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State | AK
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Zip | 99901-6074
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Country | US
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Telephone | 907-225-7445
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Fax | 907-225-8137
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Provider Business Mailing Address
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Address Line | PO BOX 1205
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City | WARD COVE
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State | AK
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Zip | 99928-1205
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Country | US
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Telephone | 503-702-3080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS JAMES GRASS
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Credential | DMD
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Telephone | 503-702-3080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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