Provider Demographics
NPI:1225121403
Name:THOMAS G. OVERMEYER D.D.S.
Entity Type:Organization
Organization Name:THOMAS G. OVERMEYER D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:OVERMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-249-0808
Mailing Address - Street 1:3221 S CONWAY RD STE C
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-7354
Mailing Address - Country:US
Mailing Address - Phone:407-249-0808
Mailing Address - Fax:407-658-4569
Practice Address - Street 1:3221 S CONWAY RD STE C
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-7354
Practice Address - Country:US
Practice Address - Phone:407-249-0808
Practice Address - Fax:407-658-4569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty