Provider Demographics
NPI:1013196401
Name:DAWSON, THOMAS WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WAYNE
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 W MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-2507
Mailing Address - Country:US
Mailing Address - Phone:817-460-1777
Mailing Address - Fax:817-460-1882
Practice Address - Street 1:909 W MITCHELL ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-2507
Practice Address - Country:US
Practice Address - Phone:817-460-1777
Practice Address - Fax:817-460-1882
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice