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General NPI Number Information
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NPI Number | 1811959240
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Entity Type | Individual
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Provider Name | PATRICK CHARLES THOMAS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 510 GYPSY LN SUITE 104
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1349
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Country | US
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Telephone | 330-884-3058
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Fax | 330-884-5788
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Provider Business Mailing Address
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Address Line | 20 MOCK ST
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City | HUBBARD
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State | OH
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Zip | 44425-1429
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Country | US
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Telephone | 330-534-1155
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Fax | 330-534-1150
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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 | 30015221
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License Number State | OH
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