Provider Demographics
NPI:1538294269
Name:THOM, DICKSON WILLIAM (DDS, ND)
Entity Type:Individual
Prefix:DR
First Name:DICKSON
Middle Name:WILLIAM
Last Name:THOM
Suffix:
Gender:M
Credentials:DDS, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9312 E. RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-614-5820
Mailing Address - Fax:480-767-2745
Practice Address - Street 1:9312 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-614-5820
Practice Address - Fax:480-767-2745
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR706175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath