Provider Demographics
NPI:1891002317
Name:SCARFE, THOMAS BANNING JR (DDS, BS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BANNING
Last Name:SCARFE
Suffix:JR
Gender:M
Credentials:DDS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11777 BERNARDO PLAZA CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2405
Mailing Address - Country:US
Mailing Address - Phone:858-376-1440
Mailing Address - Fax:
Practice Address - Street 1:11777 BERNARDO PLAZA CT
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2405
Practice Address - Country:US
Practice Address - Phone:858-376-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist