Provider Demographics
NPI:1750462826
Name:THOMASON, JANE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:MARIE
Last Name:THOMASON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:18700 N 64TH DR STE 302
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7114
Mailing Address - Country:US
Mailing Address - Phone:623-825-0100
Mailing Address - Fax:623-825-0409
Practice Address - Street 1:18700 N 64TH DR STE 302
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7114
Practice Address - Country:US
Practice Address - Phone:623-825-0100
Practice Address - Fax:623-825-0409
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry