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MAGDALYN A THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5515 W 38TH ST, INDIANAPOLIS, IN 46254-2995
(317) 880-3838
(317) 880-0081
Mailing address
592 ROCKAWAY AVE, BROOKLYN, NY 11212-5539
(718) 345-5000
(718) 345-5794

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012575A
IN
122300000X
Dentist
6018
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12012575A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
01
6018
STATE BOARD LICENSE
LA
Enumeration date
01/04/2010
Last updated
04/15/2024
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