Organization
AREA OMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARROD THOMAS DDS (PRESIDENT)
(920) 261-0495
Entity
Organization
Contact information
Practice address
301 S ROOSEVELT DR, BEAVER DAM, WI 53916-2439
(920) 365-9711
Mailing address
301 S ROOSEVELT DR, BEAVER DAM, WI 53916-2439
(920) 365-9711
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/01/2024
Last updated
01/01/2024
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