Provider Demographics
NPI:1972609667
Name:STONE, THOMAS LESLIE (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LESLIE
Last Name:STONE
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 S CLARKSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3958
Mailing Address - Country:US
Mailing Address - Phone:303-806-8600
Mailing Address - Fax:303-806-8629
Practice Address - Street 1:3701 S CLARKSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3958
Practice Address - Country:US
Practice Address - Phone:303-806-8600
Practice Address - Fax:303-806-8629
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81921223S0112X
CO38691204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH48698Medicare UPIN