Provider Demographics
NPI:1588685085
Name:THOMAS, GEORGE KUZHIPPALLIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:KUZHIPPALLIL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1529
Mailing Address - Country:US
Mailing Address - Phone:908-859-0363
Mailing Address - Fax:
Practice Address - Street 1:225 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1529
Practice Address - Country:US
Practice Address - Phone:908-859-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI218981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice