Provider Demographics
NPI:1467906826
Name:THOMAS G. RICE, III DMD, LLC
Entity Type:Organization
Organization Name:THOMAS G. RICE, III DMD, LLC
Other - Org Name:TALLADEGA DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:RICE
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-362-2182
Mailing Address - Street 1:108 NORTH ST E
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2108
Mailing Address - Country:US
Mailing Address - Phone:256-362-2182
Mailing Address - Fax:256-761-9535
Practice Address - Street 1:108 NORTH ST E
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2108
Practice Address - Country:US
Practice Address - Phone:256-362-2182
Practice Address - Fax:256-761-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5959261QD0000X
AL3599261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental