Provider Demographics
NPI:1326381096
Name:THOMAS, AURELIA MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AURELIA
Middle Name:MICHELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PINEHILL RD
Mailing Address - Street 2:LASALLE DETENTION FACILITY
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-4137
Mailing Address - Country:US
Mailing Address - Phone:318-992-7606
Mailing Address - Fax:318-992-1214
Practice Address - Street 1:830 PINEHILL RD
Practice Address - Street 2:LASALLE DETENTION FACILITY
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-4137
Practice Address - Country:US
Practice Address - Phone:318-992-7606
Practice Address - Fax:318-992-1214
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR32061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice