Provider Demographics
NPI:1013048875
Name:THOMAS E. BROOKS, D.D.S., P.A.
Entity Type:Organization
Organization Name:THOMAS E. BROOKS, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:WEST
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-467-1520
Mailing Address - Street 1:1142 EXECUTIVE CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4570
Mailing Address - Country:US
Mailing Address - Phone:919-467-9651
Mailing Address - Fax:919-467-7849
Practice Address - Street 1:1142 EXECUTIVE CIR
Practice Address - Street 2:SUITE A
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4570
Practice Address - Country:US
Practice Address - Phone:919-467-9651
Practice Address - Fax:919-467-7849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty