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Individual

DR. THOMAS MICHAEL PACKER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
24 SALT POND ROAD, SUITE F1, WAKEFIELD, RI 02879-4335
(401) 788-8820
(401) 788-9048
Mailing address
24 SALT POND ROAD, SUITE F1, WAKEFIELD, RI 02879-4335
(401) 788-8820
(401) 788-9048

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1694
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1694
DELTA DENTAL
RI
01
83496
BC DENTAL
RI
05
TP00819
RI
Enumeration date
05/08/2006
Last updated
07/08/2007
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