Provider Demographics
NPI:1336261155
Name:CABLE, THOMAS C (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:CABLE
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 1:114 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5258
Mailing Address - Country:US
Mailing Address - Phone:505-885-0350
Mailing Address - Fax:505-234-9520
Practice Address - Street 1:114 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5258
Practice Address - Country:US
Practice Address - Phone:505-885-0350
Practice Address - Fax:505-234-9520
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM14271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice