Individual
JESSICA ANNA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
5201 WASHINTON AVE STE A, RACINE, WI 53406
(262) 634-0441
Mailing address
5201 WASHINTON AVE STE A, RACINE, WI 53406
(262) 634-0441
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002559-15
WI
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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