Provider Demographics
NPI:1952855033
Name:PARDUE, THOMAS AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:AARON
Last Name:PARDUE
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 1:1985 TATE BLVD SE STE 757
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-322-4627
Mailing Address - Fax:
Practice Address - Street 1:401 MENDEL RIVERS RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-8315
Practice Address - Country:US
Practice Address - Phone:828-461-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-07
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist