Provider Demographics
NPI:1750587432
Name:PENDERS, THOMAS PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:PENDERS
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 1:830 W OLIVE AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2420
Mailing Address - Country:US
Mailing Address - Phone:209-383-6774
Mailing Address - Fax:209-722-0587
Practice Address - Street 1:830 W OLIVE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2420
Practice Address - Country:US
Practice Address - Phone:209-383-6774
Practice Address - Fax:209-722-0587
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA193781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice