Provider Demographics
NPI:1477247252
Name:THOMAS, DALLIN RAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:DALLIN
Middle Name:RAY
Last Name:THOMAS
Suffix:
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 1:304 COLT HWY APT 31
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-3075
Mailing Address - Country:US
Mailing Address - Phone:970-231-8252
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR BLDG 2
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4423
Practice Address - Country:US
Practice Address - Phone:984-974-7835
Practice Address - Fax:984-974-0290
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC132761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery