# DAVID E THOMAS, DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366602773
- **Authorized official:** MARIE CLARK (OFFICE MANAGER)
- **Authorized official phone:** (208) 454-0473

## Contact information

- **Practice address:** 616 S 10TH AVE, CALDWELL, ID 83605-4112
- **Practice address phone:** (208) 454-0473
- **Practice address fax:** (208) 454-2633
- **Mailing address:** 616 S 10TH AVE, CALDWELL, ID 83605-4112
- **Mailing address phone:** (208) 454-0473
- **Mailing address fax:** (208) 454-2633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-1857 | ID | Yes |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002768200 | — | ID |
| 05 | — | 022470 | — | OR |