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General NPI Number Information
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NPI Number | 1912588476
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Entity Type | Organization
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Legal Business Name | DAVID E THOME DDS PLLC XII
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 711 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5507
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Country | US
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Telephone | 980-729-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 8604 CLIFF CAMERON DR STE 170
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City | CHARLOTTE
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State | NC
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Zip | 28269-8508
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Country | US
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Telephone | 980-729-5200
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DAVID EUGENE THOME
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Credential | DDS
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Telephone | 980-729-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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