Provider Demographics
NPI:1124006135
Name:DAWSON, THOMAS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:DAWSON
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 1:1257 W WARNER RD
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2713
Mailing Address - Country:US
Mailing Address - Phone:480-899-7200
Mailing Address - Fax:
Practice Address - Street 1:1257 W WARNER RD
Practice Address - Street 2:SUITE B-2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2713
Practice Address - Country:US
Practice Address - Phone:480-899-7200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ 29981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice