Provider Demographics
NPI:1710197512
Name:THOMAS, LOUIS E III (DDS)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:THOMAS
Suffix:III
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 1:13810 SHANNON AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5826
Mailing Address - Country:US
Mailing Address - Phone:301-725-8530
Mailing Address - Fax:
Practice Address - Street 1:156 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1117
Practice Address - Country:US
Practice Address - Phone:410-647-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist