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NPI Code Detail

MEDICARE: DR. THOMAS GABRIEL ELIAS DMD

MEDICARE:  DR. THOMAS GABRIEL ELIAS  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
1122300000XDentist0401005816VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10006664OTHERVAANTHEM INS
2669561OTHERUNITED CONCORDIA INS

General Provider Information

NPI Number : 1548246044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS GABRIEL ELIAS DMD
Provider Business Mailing Address
First Line : 6043 HARBOUR PARK DR
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-2160
Country : US
Telephone Number : 804-739-8287
Fax Number : 804-739-3934
Provider Business Practice Location Address
First Line : 6043 HARBOUR PARK DR
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-2160
Country : US
Telephone Number : 804-739-8287
Fax Number : 804-739-3934
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 07/08/2007

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Directions to “ DR. THOMAS GABRIEL ELIAS DMD” Practice Location

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