Provider Demographics
NPI:1558357616
Name:ERIC V THOMAS DMD LLC
Entity Type:Organization
Organization Name:ERIC V THOMAS DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:V
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-465-5415
Mailing Address - Street 1:109 W ATLANTIC AVE
Mailing Address - Street 2:PO BOX 804
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2260
Mailing Address - Country:US
Mailing Address - Phone:609-465-5415
Mailing Address - Fax:609-465-1603
Practice Address - Street 1:109 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2260
Practice Address - Country:US
Practice Address - Phone:609-465-5415
Practice Address - Fax:609-465-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1018036001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty