Provider Demographics
NPI:1760464978
Name:BERMEL, THOMAS L (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:BERMEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9696 CHERRYVALE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4912
Mailing Address - Country:US
Mailing Address - Phone:303-799-8557
Mailing Address - Fax:303-980-2332
Practice Address - Street 1:9025 E MINERAL CIRCLE
Practice Address - Street 2:SUITE 101
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3449
Practice Address - Country:US
Practice Address - Phone:303-799-8557
Practice Address - Fax:303-980-2332
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO58831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice