Individual
FAIRLY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
98 ROUTE 202 AT PA DE LINE, CHADDS FORD, PA 19317
(610) 459-4915
(610) 459-9752
Mailing address
13 WYNDOM CT, HOCKESSIN, DE 19707-2511
(302) 235-7151
(610) 459-9752
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0303821
PA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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