Provider Demographics
NPI:1306398391
Name:LAWTON C THOMAS JR D.M.D
Entity Type:Organization
Organization Name:LAWTON C THOMAS JR D.M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-487-8621
Mailing Address - Street 1:288 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1534
Mailing Address - Country:US
Mailing Address - Phone:201-487-8621
Mailing Address - Fax:
Practice Address - Street 1:288 MAIN STREET
Practice Address - Street 2:
Practice Address - City:RDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660
Practice Address - Country:US
Practice Address - Phone:201-487-8621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental