Provider Demographics
NPI:1891853099
Name:MARKUSON, THOMAS KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KENT
Last Name:MARKUSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W REMINGTON DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2470
Mailing Address - Country:US
Mailing Address - Phone:408-737-3900
Mailing Address - Fax:
Practice Address - Street 1:516 W REMINGTON DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2470
Practice Address - Country:US
Practice Address - Phone:408-737-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist