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General NPI Number Information
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NPI Number | 1386639607
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Entity Type | Individual
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Provider Name | JOHN A THOMAS D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 4700 LAS VEGAS BLVD N SUITE 2419, BLDG 1300
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City | NELLIS AFB
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State | NV
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Zip | 89191-6600
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Country | US
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Telephone | 702-653-2600
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Fax | 702-653-2682
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Provider Business Mailing Address
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Address Line | 1867 MUCHACHA DR
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City | HENDERSON
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State | NV
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Zip | 89014-4501
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Country | US
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Telephone | 210-219-7146
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 7366
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License Number State | CO
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