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General NPI Number Information
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NPI Number | 1538248307
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Entity Type | Organization
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Legal Business Name | WEST MICHIGAN ENDODONTICS PC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 5033 W MICHIGAN AVE
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City | KALAMAZOO
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State | MI
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Zip | 49006-5730
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Country | US
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Telephone | 269-375-7006
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Fax | 269-375-0756
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Provider Business Mailing Address
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Address Line | 5033 W MICHIGAN AVE
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City | KALAMAZOO
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State | MI
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Zip | 49006-5730
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Country | US
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Telephone | 269-375-7006
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Fax | 269-375-0756
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN E THOMAS
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Credential | D.D.S., M.S.
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Telephone | 269-375-7006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 20151
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License Number State | MI
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