Provider Demographics
NPI:1477613925
Name:CLOYD, G. THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:G.
Middle Name:THOMAS
Last Name:CLOYD
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:PO BOX 160
Mailing Address - Street 2:1792A EAST STATE HWY 163
Mailing Address - City:CLINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47842-0160
Mailing Address - Country:US
Mailing Address - Phone:765-832-7741
Mailing Address - Fax:765-832-7743
Practice Address - Street 1:1792 E STATE ROAD 163
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842-7327
Practice Address - Country:US
Practice Address - Phone:765-832-7741
Practice Address - Fax:765-832-7743
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice