Provider Demographics
NPI:1629188156
Name:THOMAS, PETER ALBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ALBERT
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 1:2 DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-3318
Mailing Address - Country:US
Mailing Address - Phone:603-926-8827
Mailing Address - Fax:
Practice Address - Street 1:2 DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-3318
Practice Address - Country:US
Practice Address - Phone:603-926-8827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89191586Medicaid