Provider Demographics
NPI:1710196456
Name:THOMAS, RICHARD K (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
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 1:5 N MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2317
Mailing Address - Country:US
Mailing Address - Phone:508-359-6600
Mailing Address - Fax:508-359-8710
Practice Address - Street 1:19 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2908
Practice Address - Country:US
Practice Address - Phone:508-359-1898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice