Provider Demographics
NPI:1588238463
Name:DAVID E THOME DDS PLLC XI
Entity Type:Organization
Organization Name:DAVID E THOME DDS PLLC XI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-729-5200
Mailing Address - Street 1:8604 CLIFF CAMERON DR STE 170
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8508
Mailing Address - Country:US
Mailing Address - Phone:980-729-5200
Mailing Address - Fax:
Practice Address - Street 1:5708 N SHARON AMITY RD STE 5708-A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-5082
Practice Address - Country:US
Practice Address - Phone:980-729-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty