Provider Demographics
NPI:1326716390
Name:GREGORY P THOMAS, DDS, MD,P.C.
Entity Type:Organization
Organization Name:GREGORY P THOMAS, DDS, MD,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:312-926-2929
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 2280
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2920
Mailing Address - Country:US
Mailing Address - Phone:312-926-2929
Mailing Address - Fax:312-926-3595
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2280
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2920
Practice Address - Country:US
Practice Address - Phone:312-926-2929
Practice Address - Fax:312-926-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty