Provider Demographics
NPI:1477732063
Name:ME THOMAS DENTAL CORP
Entity Type:Organization
Organization Name:ME THOMAS DENTAL CORP
Other - Org Name:MIDTOWN FAMILY DENTAL OFFICE DENTAL OFFICE OF ME THOMAS DENTAL CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-407-8409
Mailing Address - Street 1:3500 TRUXTUN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3018
Mailing Address - Country:US
Mailing Address - Phone:661-407-8409
Mailing Address - Fax:661-407-8379
Practice Address - Street 1:3500 TRUXTUN AVE STE B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3018
Practice Address - Country:US
Practice Address - Phone:661-861-0577
Practice Address - Fax:661-407-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty