Provider Demographics
NPI:1235293564
Name:NEAFUS, THOMAS ERIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ERIK
Last Name:NEAFUS
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 1:12 WILDFLOWER PL
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6221
Mailing Address - Country:US
Mailing Address - Phone:651-340-1318
Mailing Address - Fax:
Practice Address - Street 1:700 VILLAGE CENTER DR
Practice Address - Street 2:SUITE 150
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-3019
Practice Address - Country:US
Practice Address - Phone:651-481-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND111361223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics