Individual
DR. THOMAS GENE MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4550 S IRONWOOD DR, SOUTH BEND, IN 46614-9595
(574) 299-0484
(574) 299-0447
Mailing address
4550 S IRONWOOD DR, SOUTH BEND, IN 46614-9595
(574) 299-0484
(574) 299-0447
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010309A
IN
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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