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NPI Code Detail

MEDICARE: THOMAS J MCDONALD DDS PC

MEDICARE: THOMAS J MCDONALD DDS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center14262MI

General Provider Information

NPI Number : 1366896490
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS J MCDONALD DDS PC
Provider Business Mailing Address
First Line : 117 S KINNEY AVE
Second Line :
City : MT PLEASANT
State : MI
Zip : 48858-2702
Country : US
Telephone Number : 989-773-2133
Fax Number : 989-779-1054
Provider Business Practice Location Address
First Line : 117 S KINNEY AVE
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-2702
Country : US
Telephone Number : 989-773-2133
Fax Number : 989-779-1054
Authorized Official
Title or Position : OWNER
Name : DR. THOMAS JOHN MCDONALD
Credential :
Telephone Number : 989-773-2133
Provider Enumeration Date : 04/14/2016
Last Update Date : 12/14/2021

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Directions to “THOMAS J MCDONALD DDS PC ” Practice Location

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