Provider Demographics
NPI:1467473991
Name:MCLAUGHLIN, THOMAS R (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 RIO PINAR DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3825
Mailing Address - Country:US
Mailing Address - Phone:386-672-6581
Mailing Address - Fax:386-672-6589
Practice Address - Street 1:785 W GRANADA BLVD
Practice Address - Street 2:SUITE #3
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9522
Practice Address - Country:US
Practice Address - Phone:386-672-6581
Practice Address - Fax:386-672-6589
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN58061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice