Provider Demographics
NPI:1093226441
Name:THOMAS, KITTY ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:KITTY
Middle Name:ELIZABETH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 85TH ST APT 4J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4723
Mailing Address - Country:US
Mailing Address - Phone:347-264-0251
Mailing Address - Fax:
Practice Address - Street 1:402 85TH ST APT 4J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4723
Practice Address - Country:US
Practice Address - Phone:347-264-0251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02692600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist