Provider Demographics
NPI:1609998525
Name:THOMAS, ROY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:L
Last Name:THOMAS
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 1:26535 CARMEL RANCHO BLVD
Mailing Address - Street 2:SUITE 5-A
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8749
Mailing Address - Country:US
Mailing Address - Phone:831-625-2255
Mailing Address - Fax:
Practice Address - Street 1:26535 CARMEL RANCHO BLVD
Practice Address - Street 2:SUITE 5-A
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8749
Practice Address - Country:US
Practice Address - Phone:831-625-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice