Provider Demographics
NPI:1912082280
Name:CALL, THOMAS FLANDRE (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FLANDRE
Last Name:CALL
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 1:1352 E CENTER
Mailing Address - Street 2:STE B
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201
Mailing Address - Country:US
Mailing Address - Phone:208-233-2500
Mailing Address - Fax:208-232-2195
Practice Address - Street 1:1352 E CENTER
Practice Address - Street 2:STE B
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201
Practice Address - Country:US
Practice Address - Phone:208-233-2500
Practice Address - Fax:208-232-2195
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID18471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice