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General NPI Number Information
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NPI Number | 1235708983
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Entity Type | Individual
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Provider Name | KASEY THOMAS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 850 NORMAN DR
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City | LEBANON
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State | PA
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Zip | 17042-7444
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Country | US
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Telephone | 717-272-3079
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Fax |
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Provider Business Mailing Address
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Address Line | 382 OLD MINE RD
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City | LEBANON
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State | PA
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Zip | 17042-9245
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS043111
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License Number State | PA
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