Provider Demographics
NPI:1649373879
Name:YORK, THOMAS JOHN (DDS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOHN
Last Name:YORK
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 1:1102 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-6284
Mailing Address - Country:US
Mailing Address - Phone:701-223-4915
Mailing Address - Fax:701-224-9928
Practice Address - Street 1:1102 S WASHINGTON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-6284
Practice Address - Country:US
Practice Address - Phone:701-223-4915
Practice Address - Fax:701-224-9928
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist