Provider Demographics
NPI:1578608436
Name:SKELTON, THOMAS E (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:SKELTON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15947 RED FOX LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3725
Mailing Address - Country:US
Mailing Address - Phone:719-487-9303
Mailing Address - Fax:
Practice Address - Street 1:8540 SCARBOROUGH DR.
Practice Address - Street 2:SUITE 250
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-487-9303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics