Provider Demographics
NPI:1093056707
Name:ROBERT G. THOMAS D.D.S. M.S. LTD.
Entity Type:Organization
Organization Name:ROBERT G. THOMAS D.D.S. M.S. LTD.
Other - Org Name:THOMAS ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:630-904-7600
Mailing Address - Street 1:3124 SOUTH ROUTE 59 SUITE 132
Mailing Address - Street 2:THOMAS ORTHODONTICS
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-904-7600
Mailing Address - Fax:630-904-6501
Practice Address - Street 1:3124 SOUTH ROUTE 59 SUITE 132
Practice Address - Street 2:THOMAS ORTHODONTICS
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-904-7600
Practice Address - Fax:630-904-6501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT G. THOMAS D.D.S. M.S. LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty