MEDICARE: JAMES D. THOMAS, 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
1	1223G0001X	General Practice Dentistry	1223G0001X	MI

General Provider Information

NPI Number	:	1619412145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES D. THOMAS, DDS, PC

Provider Business Mailing Address
First Line	:	6240 HILL ST
Second Line	:
City	:	CASS CITY
State	:	MI
Zip	:	48726-9015
Country	:	US
Telephone Number	:	989-872-3870
Fax Number	:	989-872-4582

Provider Business Practice Location Address
First Line	:	6240 HILL ST
Second Line	:
City	:	CASS CITY
State	:	MI
Zip	:	48726-9015
Country	:	US
Telephone Number	:	989-872-3870
Fax Number	:	989-872-4582

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. JAMES THOMAS
Credential	:	DDS
Telephone Number	:	989-872-3870

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	12/19/2016

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