Individual
MARK ALLEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
408 LANCASTER DR NE, SALEM, OR 97301-4728
(503) 362-3032
(503) 362-4647
Mailing address
4664 TRAGEN CT SE, SALEM, OR 97302-3533
(503) 364-5607
(503) 362-4647
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6205
OR
Other
Enumeration date
11/15/2006
Last updated
10/10/2012
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