Provider Demographics
NPI:1578642666
Name:BEFFA, THOMAS C (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:BEFFA
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 1:124 S NORMANDY ROAD
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1790
Mailing Address - Country:US
Mailing Address - Phone:206-242-0066
Mailing Address - Fax:206-242-0069
Practice Address - Street 1:124 S NORMANDY ROAD
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1790
Practice Address - Country:US
Practice Address - Phone:206-242-0066
Practice Address - Fax:206-242-0069
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000040501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice