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NPI Code Detail

MEDICARE: DR. CANDACE R THOMAS DDS

MEDICARE:  DR. CANDACE R THOMAS  DDS
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
11223G0001XGeneral Practice DentistryDN013894GA

General Provider Information

NPI Number : 1538494240
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CANDACE R THOMAS DDS
Provider Business Mailing Address
First Line : 236 STOCKBRIDGE RD STE A
Second Line :
City : JONESBORO
State : GA
Zip : 30236-3629
Country : US
Telephone Number : 678-619-2467
Fax Number :
Provider Business Practice Location Address
First Line : 236 STOCKBRIDGE RD STE A
Second Line :
City : JONESBORO
State : GA
Zip : 30236-3629
Country : US
Telephone Number : 678-619-2467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2009
Last Update Date : 01/27/2012

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Directions to “ DR. CANDACE R THOMAS DDS” Practice Location

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