Provider Demographics
NPI:1780799858
Name:THOMAS T DOAN DMD
Entity type:Organization
Organization Name:THOMAS T DOAN DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-365-4418
Mailing Address - Street 1:1999 LINCOLN DR
Mailing Address - Street 2:#102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236
Mailing Address - Country:US
Mailing Address - Phone:941-365-4418
Mailing Address - Fax:941-365-2704
Practice Address - Street 1:1999 LINCOLN DR
Practice Address - Street 2:#102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236
Practice Address - Country:US
Practice Address - Phone:941-365-4418
Practice Address - Fax:941-365-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN151331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty