Provider Demographics
NPI:1760602734
Name:THOMAS C. BRICK D.M.D. PA.
Entity Type:Organization
Organization Name:THOMAS C. BRICK D.M.D. PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-262-1341
Mailing Address - Street 1:855 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6004
Mailing Address - Country:US
Mailing Address - Phone:239-262-1341
Mailing Address - Fax:239-262-7154
Practice Address - Street 1:855 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6004
Practice Address - Country:US
Practice Address - Phone:239-262-1341
Practice Address - Fax:239-262-7154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental