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General NPI Number Information
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NPI Number | 1891127155
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Entity Type | Organization
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Legal Business Name | RYAN C THOMAS, DDS, PLLC
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 2600 VILLAGE PKWY SUITE 120
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-3601
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Country | US
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Telephone | 603-203-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 508 NEWPORT DR
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City | FLOWER MOUND
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State | TX
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Zip | 75028-7260
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Country | US
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Telephone | 603-203-5020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN CLARK THOMAS
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Credential | D.D.S.
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Telephone | 603-203-5020
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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 | 28604
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License Number State | TX
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