Provider Demographics
NPI:1184713695
Name:SALMON, THOMAS N (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:SALMON
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 1:1573 W FAIRBANKS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4679
Mailing Address - Country:US
Mailing Address - Phone:407-644-0224
Mailing Address - Fax:407-644-2827
Practice Address - Street 1:1573 W FAIRBANKS AVE
Practice Address - Street 2:300
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4679
Practice Address - Country:US
Practice Address - Phone:407-644-0224
Practice Address - Fax:407-644-2827
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN93931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU01507Medicare UPIN