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General NPI Number Information
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NPI Number | 1669422127
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Entity Type | Individual
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Provider Name | PRIYA M THOMAS DDS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 1121 W MICHIGAN STEET DS307B
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5186
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Country | US
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Telephone | 317-278-3632
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Fax | 317-274-2603
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Provider Business Mailing Address
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Address Line | 1121 W MICHIGAN STREET DS307B
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5186
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Country | US
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Telephone | 317-278-3632
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Fax | 317-274-2603
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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 | 2901019059
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12011041A
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License Number State | IN
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