MEDICARE: DR. JAMES DAVID THOMAS D.D.S.

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	2901016993	MI

General Provider Information

NPI Number	:	1710108287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DAVID THOMAS D.D.S.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/15/2019

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