Provider Demographics
NPI:1205882156
Name:VALE, THOMAS CURTIS (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CURTIS
Last Name:VALE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 N CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1510
Mailing Address - Country:US
Mailing Address - Phone:989-732-2741
Mailing Address - Fax:989-731-0321
Practice Address - Street 1:860 N CENTER AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1510
Practice Address - Country:US
Practice Address - Phone:989-732-2741
Practice Address - Fax:989-731-0321
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID173551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice