MEDICARE: MR. THOMAS KENT DEAN DMD

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
1	1223G0001X	General Practice Dentistry	D6806	OR

General Provider Information

NPI Number	:	1477656833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS KENT DEAN DMD

Provider Business Mailing Address
First Line	:	1995 BAILEY HILL RD
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405
Country	:	US
Telephone Number	:	541-344-4704
Fax Number	:	541-302-6654

Provider Business Practice Location Address
First Line	:	1995 BAILEY HILL RD
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405
Country	:	US
Telephone Number	:	541-344-4704
Fax Number	:	541-302-6654

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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