Provider Demographics
NPI:1346581956
Name:THOMAS, MICHAEL ANPHONEY JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANPHONEY
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2484 BRIARCLIFF RD NE STE 29
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3011
Mailing Address - Country:US
Mailing Address - Phone:404-315-7375
Mailing Address - Fax:
Practice Address - Street 1:3535 ROSWELL RD STE 3
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8827
Practice Address - Country:US
Practice Address - Phone:770-627-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014649122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty