Provider Demographics
NPI:1235136037
Name:RATLIFF, THOMAS LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LOUIS
Last Name:RATLIFF
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 1:15962 SW TUALATIN SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8690
Mailing Address - Country:US
Mailing Address - Phone:503-330-5385
Mailing Address - Fax:503-925-0243
Practice Address - Street 1:15962 SW TUALATIN SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8690
Practice Address - Country:US
Practice Address - Phone:503-330-5385
Practice Address - Fax:503-925-0243
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD57831223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice