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General NPI Number Information
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NPI Number | 1629110549
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Entity Type | Organization
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Legal Business Name | GEALON A THOMAS DDS PLLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 111 PEACOCK COURT
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City | SEYMOUR
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State | TN
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Zip | 37865
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Country | US
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Telephone | 865-573-0274
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Fax | 865-577-0174
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Provider Business Mailing Address
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Address Line | 111 PEACOCK COURT
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City | SEYMOUR
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State | TN
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Zip | 37865
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Country | US
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Telephone | 865-573-0274
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Fax | 865-577-0174
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. GEALON A THOMAS
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Credential | DDS
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Telephone | 865-573-0274
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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 |
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License Number State |
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