Provider Demographics
NPI:1609924869
Name:LUSBY, THOMAS FRANK III (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANK
Last Name:LUSBY
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:6200 SANDY POINT RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-5770
Mailing Address - Country:US
Mailing Address - Phone:410-535-0066
Mailing Address - Fax:
Practice Address - Street 1:135 W DARES BEACH RD
Practice Address - Street 2:SUITE 209
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3119
Practice Address - Country:US
Practice Address - Phone:410-535-0001
Practice Address - Fax:410-535-5624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD068391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery