Provider Demographics
NPI:1750038352
Name:DENTON, THOMAS B
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:DENTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONG SHOALS RD APT 11I
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-7751
Mailing Address - Country:US
Mailing Address - Phone:803-610-5564
Mailing Address - Fax:
Practice Address - Street 1:300 LONG SHOALS RD APT 11I
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-7751
Practice Address - Country:US
Practice Address - Phone:803-610-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program