Provider Demographics
NPI:1710005665
Name:EISCHEID, THOMAS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:EISCHEID
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 1:3121 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6306
Mailing Address - Country:US
Mailing Address - Phone:510-523-5323
Mailing Address - Fax:510-864-7769
Practice Address - Street 1:2111 WHITEHALL PL
Practice Address - Street 2:SUITE C
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6160
Practice Address - Country:US
Practice Address - Phone:514-052-3532
Practice Address - Fax:510-864-7769
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice