Provider Demographics
NPI:1649395500
Name:THOMAS, LLOYD GEORGE JR (DDS)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:GEORGE
Last Name:THOMAS
Suffix:JR
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 1:1136 EAST STUART ST
Mailing Address - Street 2:SUITE 4103
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1173
Mailing Address - Country:US
Mailing Address - Phone:970-221-2444
Mailing Address - Fax:970-221-4360
Practice Address - Street 1:1136 EAST STUART ST
Practice Address - Street 2:SUITE 4103
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1173
Practice Address - Country:US
Practice Address - Phone:970-221-2444
Practice Address - Fax:970-221-4360
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2921223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics