Provider Demographics
NPI:1821169061
Name:FUCHS, THOMAS M (DMD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:FUCHS
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 1:10907 TALON WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5579
Mailing Address - Country:US
Mailing Address - Phone:502-253-0260
Mailing Address - Fax:
Practice Address - Street 1:305 MIDDLETOWN PARK PL
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2514
Practice Address - Country:US
Practice Address - Phone:502-253-0008
Practice Address - Fax:502-253-0039
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY60321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice