Provider Demographics
NPI:1710108287
Name:THOMAS, JAMES DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
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 1:6240 HILL ST
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-9015
Mailing Address - Country:US
Mailing Address - Phone:989-872-3870
Mailing Address - Fax:989-872-4582
Practice Address - Street 1:6240 HILL ST
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-9015
Practice Address - Country:US
Practice Address - Phone:989-872-3870
Practice Address - Fax:989-872-4582
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010169931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice