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General NPI Number Information
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NPI Number | 1225478290
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Entity Type | Individual
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Provider Name | THOMAS O'SHEA
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Gender | Male
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Dates
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Enumeration Date | 07/04/2013
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 37601 GOLDEN BEACH RD
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City | CHARLOTTE HALL
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State | MD
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Zip | 20622-3060
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Country | US
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Telephone | 301-884-2299
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Fax |
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Provider Business Mailing Address
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Address Line | 8167 DEER CHASE LN DEER CHASE
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-4625
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15360
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License Number State | MD
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