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General NPI Number Information
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NPI Number | 1285244780
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Entity Type | Individual
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Provider Name | THOMAS JAMES BOOKER DMD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 2780 W HORIZON RIDGE PKWY STE 20
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City | HENDERSON
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State | NV
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Zip | 89052-3995
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Country | US
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Telephone | 702-719-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 10705 SAPPHIRE VISTA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89144-4139
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Country | US
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Telephone | 702-287-2029
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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 | 7390
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License Number State | NV
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