Provider Demographics
NPI:1598006793
Name:THOMAS J. EIGO, DDS, PC
Entity Type:Organization
Organization Name:THOMAS J. EIGO, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:EIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-793-5138
Mailing Address - Street 1:516 GLEN ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2231
Mailing Address - Country:US
Mailing Address - Phone:518-793-5138
Mailing Address - Fax:518-792-7538
Practice Address - Street 1:516 GLEN ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2231
Practice Address - Country:US
Practice Address - Phone:518-793-5138
Practice Address - Fax:518-792-7538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0442281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty