Organization
FOSSIL DENTAL
Active
Parent organization
WALTER D. THAMES, PLLC
Other names
Fossil Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALTER D. THAMES, PLLC
Authorized official
DR. WALTER D THAMES DDS, MS (OWNER/DENTIST)
(210) 888-5832
Entity
Organization
Contact information
Practice address
8142 SHIN OAK DR STE 100, LIVE OAK, TX 78233-2775
(210) 888-5832
Mailing address
8142 SHIN OAK DR STE 100, LIVE OAK, TX 78233-2775
(210) 888-5832
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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