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General NPI Number Information
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NPI Number | 1457247447
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Entity Type | Individual
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Provider Name | KIRSTIE SARAH THOMAS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1241 FARMINGTON LAKES DR # 5109
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City | OSWEGO
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State | IL
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Zip | 60543-5109
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Country | US
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Telephone | 630-299-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 13441 KERR ST
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City | PLAINFIELD
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State | IL
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Zip | 60585
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Country | US
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Telephone | 331-250-5996
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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 | 019.035307
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License Number State | IL
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