Provider Demographics
NPI:1205954740
Name:THOMAS, CHARLES JOSEPH II (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOSEPH
Last Name:THOMAS
Suffix:II
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 1:49 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6312
Mailing Address - Country:US
Mailing Address - Phone:603-472-2943
Mailing Address - Fax:
Practice Address - Street 1:6 LOUDON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5321
Practice Address - Country:US
Practice Address - Phone:603-224-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH035631223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics