Provider Demographics
NPI:1508915125
Name:WESCOTT, THOMAS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:WESCOTT
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 1:200 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2364
Mailing Address - Country:US
Mailing Address - Phone:856-231-1441
Mailing Address - Fax:856-231-0997
Practice Address - Street 1:200 W 3RD ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2364
Practice Address - Country:US
Practice Address - Phone:856-231-1441
Practice Address - Fax:856-231-0997
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics