Provider Demographics
NPI:1093970782
Name:AUSTIN, THOMAS M (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:AUSTIN
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 1:5061 LEE PT
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:NC
Mailing Address - Zip Code:28682-9775
Mailing Address - Country:US
Mailing Address - Phone:828-478-2629
Mailing Address - Fax:
Practice Address - Street 1:5061 LEE PT
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:NC
Practice Address - Zip Code:28682-9775
Practice Address - Country:US
Practice Address - Phone:828-478-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist