Provider Demographics
NPI:1780364695
Name:HAWKINS, THOMAS ARIC (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ARIC
Last Name:HAWKINS
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 1:133 BAY STATE RD APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1716
Mailing Address - Country:US
Mailing Address - Phone:850-212-7951
Mailing Address - Fax:
Practice Address - Street 1:1810 WASHINGTON ST STE 3&4
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1685
Practice Address - Country:US
Practice Address - Phone:508-499-8435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist