Provider Demographics
NPI:1245896430
Name:DR. THOMAS J PASTOR DDS PA
Entity type:Organization
Organization Name:DR. THOMAS J PASTOR DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PASTOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-418-7387
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:EAST WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04234-0390
Mailing Address - Country:US
Mailing Address - Phone:207-645-9522
Mailing Address - Fax:
Practice Address - Street 1:1445 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST WILTON
Practice Address - State:ME
Practice Address - Zip Code:04234
Practice Address - Country:US
Practice Address - Phone:207-645-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental