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General NPI Number Information
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NPI Number | 1366896490
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Entity Type | Organization
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Legal Business Name | THOMAS J MCDONALD DDS PC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 117 S KINNEY AVE
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-2702
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Country | US
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Telephone | 989-773-2133
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Fax | 989-779-1054
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Provider Business Mailing Address
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Address Line | 117 S KINNEY AVE
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City | MT PLEASANT
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State | MI
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Zip | 48858-2702
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Country | US
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Telephone | 989-773-2133
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Fax | 989-779-1054
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS JOHN MCDONALD
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Credential |
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Telephone | 989-773-2133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14262
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License Number State | MI
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