Provider Demographics
NPI:1912927641
Name:UNRUH, THOMAS (DDS, PC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:UNRUH
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 US HIGHWAY 395 N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4314
Mailing Address - Country:US
Mailing Address - Phone:775-782-0411
Mailing Address - Fax:775-783-8611
Practice Address - Street 1:1664 US HIGHWAY 395 N
Practice Address - Street 2:SUITE 202
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4314
Practice Address - Country:US
Practice Address - Phone:775-782-0411
Practice Address - Fax:775-783-8611
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice