Provider Demographics
NPI:1689892887
Name:THOMAS, RICHARD G (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
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 1:5532 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1504
Mailing Address - Country:US
Mailing Address - Phone:419-539-2168
Mailing Address - Fax:419-539-2166
Practice Address - Street 1:5532 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1504
Practice Address - Country:US
Practice Address - Phone:419-539-2168
Practice Address - Fax:419-539-2166
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-76231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice