Provider Demographics
NPI:1639167869
Name:KAMINSKY, THOMAS KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KEITH
Last Name:KAMINSKY
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 1:422 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:16242-1103
Mailing Address - Country:US
Mailing Address - Phone:814-275-1233
Mailing Address - Fax:
Practice Address - Street 1:422 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:16242-1103
Practice Address - Country:US
Practice Address - Phone:814-275-1233
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028000L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice