Individual
THOMAS CHISAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2052 HARRIS PIKE # 54, INDEPENDENCE, KY 41051-7783
(859) 898-2255
Mailing address
184 SOUTHPORT, WILLIAMSBURG, VA 23188-8937
(757) 285-9812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11380
KY
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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