Provider Demographics
NPI:1154462547
Name:KING, THOMAS P (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:KING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 GADSDEN HWY
Mailing Address - Street 2:SUITE201
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2565
Mailing Address - Country:US
Mailing Address - Phone:205-836-6050
Mailing Address - Fax:
Practice Address - Street 1:628 GADSDEN HWY
Practice Address - Street 2:SUITE201
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-2565
Practice Address - Country:US
Practice Address - Phone:205-836-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL535068OtherUNITED CONCORDIA
AL51093932OtherBLUE CROSS BLUE SHIELD