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General NPI Number Information
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NPI Number | 1689568834
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Entity Type | Individual
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Provider Name | TAMERA THOMAS DDS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3320 RUTGER ST
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1122
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Country | US
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Telephone | 314-977-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 4073 PORTLAND RIDGE DR
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City | FLORISSANT
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State | MO
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Zip | 63034-2451
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Country | US
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Telephone | 314-374-9739
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2025048580
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License Number State | MO
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