Provider Demographics
NPI:1033569892
Name:THAMES, STONE (DMD)
Entity Type:Individual
Prefix:DR
First Name:STONE
Middle Name:
Last Name:THAMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 OLD AMY RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-2139
Mailing Address - Country:US
Mailing Address - Phone:601-649-2010
Mailing Address - Fax:
Practice Address - Street 1:1615 OLD AMY RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-2139
Practice Address - Country:US
Practice Address - Phone:601-649-2010
Practice Address - Fax:601-649-0062
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3858-16122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist