Provider Demographics
NPI:1497076079
Name:THOMAS, CAMERON JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:JAMES
Last Name:THOMAS
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 1:1411 J F KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3639
Mailing Address - Country:US
Mailing Address - Phone:402-291-3535
Mailing Address - Fax:402-291-0760
Practice Address - Street 1:1411 J F KENNEDY DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3639
Practice Address - Country:US
Practice Address - Phone:402-291-3535
Practice Address - Fax:402-291-0760
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24041223D0001X
NE73031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health