Provider Demographics
NPI:1851436604
Name:TOHILL, THOMAS A (DMD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:TOHILL
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 1:101 SARAHS LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2775
Mailing Address - Country:US
Mailing Address - Phone:606-679-4450
Mailing Address - Fax:606-677-1418
Practice Address - Street 1:101 SARAHS LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2775
Practice Address - Country:US
Practice Address - Phone:606-679-4450
Practice Address - Fax:606-677-1418
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60047644Medicaid