Provider Demographics
NPI:1770551723
Name:SORENSEN, THOMAS COOLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:COOLEY
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:2575 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-4473
Mailing Address - Country:US
Mailing Address - Phone:775-753-6118
Mailing Address - Fax:775-738-2731
Practice Address - Street 1:6095 FASHION BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7397
Practice Address - Country:US
Practice Address - Phone:801-268-4986
Practice Address - Fax:801-268-8817
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVS6-34C1223P0221X
UT140796-99221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry