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Organization

THOMAS DENTAL GROUP PA

Active
Other names
Dr. Bob Maley Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN JOHN THOMAS DDS (OWNER)
(651) 261-3713
Entity
Organization

Contact information

Practice address
1150 MONTREAL AVE STE 104, SAINT PAUL, MN 55116-2393
(651) 224-0001
Mailing address
1150 MONTREAL AVE STE 104, SAINT PAUL, MN 55116-2393
(651) 224-0001

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336296409
DENTAL
MN
01
1861849176
DENTAL
MN
Enumeration date
11/24/2020
Last updated
11/24/2020
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