Provider Demographics
NPI:1972941870
Name:DAVID E THOME DDS PA I
Entity Type:Organization
Organization Name:DAVID E THOME DDS PA I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-604-0353
Mailing Address - Street 1:140 MAHALEY AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2449
Mailing Address - Country:US
Mailing Address - Phone:704-637-5506
Mailing Address - Fax:704-943-0593
Practice Address - Street 1:140 MAHALEY AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2449
Practice Address - Country:US
Practice Address - Phone:704-637-5506
Practice Address - Fax:704-943-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty