Provider Demographics
NPI:1407215619
Name:THOMAS MAXWELL THANEY D.D.S.
Entity Type:Organization
Organization Name:THOMAS MAXWELL THANEY D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:THANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-637-6884
Mailing Address - Street 1:64 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1649
Mailing Address - Country:US
Mailing Address - Phone:585-637-6884
Mailing Address - Fax:585-637-7087
Practice Address - Street 1:64 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1649
Practice Address - Country:US
Practice Address - Phone:585-637-6884
Practice Address - Fax:585-637-7087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0512921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty