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General NPI Number Information
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NPI Number | 1285184408
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Entity Type | Organization
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Legal Business Name | THOMAS G BINGHAM, DDS, PLLC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 4041 W WHEATLAND RD STE 202
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City | DALLAS
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State | TX
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Zip | 75237-4061
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Country | US
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Telephone | 972-780-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 3622 APPALACHIAN WAY
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City | FLOWER MOUND
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State | TX
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Zip | 75022-7823
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Country | US
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Telephone | 972-355-7194
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS BINGHAM
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Credential | DDS
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Telephone | 972-355-7194
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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 | 23529
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License Number State | TX
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