Provider Demographics
NPI:1083741714
Name:CENCER, THOMAS W (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:CENCER
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 1:455 BARCLAY CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4774
Mailing Address - Country:US
Mailing Address - Phone:248-853-5401
Mailing Address - Fax:248-853-5877
Practice Address - Street 1:455 BARCLAY CIR
Practice Address - Street 2:SUITE A
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4774
Practice Address - Country:US
Practice Address - Phone:248-853-5401
Practice Address - Fax:248-853-5877
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010132331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice