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Organization
THOMAS DENTAL GROUP PA
Active
Organization
THOMAS DENTAL GROUP PA
Active
Other names
Dr. Bob Maley Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN JOHN THOMAS DDS (OWNER)
(651) 261-3713
Entity
Organization
Contact information
Practice address
1150 MONTREAL AVE STE 104, SAINT PAUL, MN 55116-2393
(651) 224-0001
Mailing address
1150 MONTREAL AVE STE 104, SAINT PAUL, MN 55116-2393
(651) 224-0001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336296409
DENTAL
MN
01
—
1861849176
DENTAL
MN
Enumeration date
11/24/2020
Last updated
11/24/2020
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