Provider Demographics
NPI:1750626149
Name:BANDY, THOMAS E (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:BANDY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6196
Mailing Address - Country:US
Mailing Address - Phone:724-625-8071
Mailing Address - Fax:
Practice Address - Street 1:168518 BANNOK RD SR331
Practice Address - Street 2:BELMONT CORRECTIONAL INSTITUTION
Practice Address - City:ST. CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-695-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.022956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist