Provider Demographics
NPI:1346443603
Name:THOMAS S. BROWDER DDS
Entity Type:Organization
Organization Name:THOMAS S. BROWDER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-998-9988
Mailing Address - Street 1:5380 US HIGHWAY 158
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6907
Mailing Address - Country:US
Mailing Address - Phone:336-998-9988
Mailing Address - Fax:336-998-6331
Practice Address - Street 1:5380 US HIGHWAY 158
Practice Address - Street 2:SUITE 200
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-6907
Practice Address - Country:US
Practice Address - Phone:336-998-9988
Practice Address - Fax:336-998-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6654122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6654OtherNC STATE DENTAL LICENSE #
NC899003NMedicaid