Provider Demographics
NPI:1528219250
Name:MAREING, THOMAS M (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:MAREING
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 1:10220 S. CICERO AVE
Mailing Address - Street 2:SUITE 101-103
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:708-499-2266
Mailing Address - Fax:708-499-2292
Practice Address - Street 1:10220 S. CICERO AVE
Practice Address - Street 2:SUITE 101-103
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:708-499-2266
Practice Address - Fax:708-499-2292
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A152861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice