Provider Demographics
NPI:1255060406
Name:THOMAS ST. GERMAIN, D.D.S., P.C.
Entity type:Organization
Organization Name:THOMAS ST. GERMAIN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:ST GERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-968-2469
Mailing Address - Street 1:12021 SHAMROCK PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3533
Mailing Address - Country:US
Mailing Address - Phone:402-330-2243
Mailing Address - Fax:402-330-0408
Practice Address - Street 1:12021 SHAMROCK PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3533
Practice Address - Country:US
Practice Address - Phone:402-330-2243
Practice Address - Fax:402-330-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty