Organization
DAVID E THOME DDS PLLC IV
Active
Other names
Statesville Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LUCENDA HARRIS (CREDENTIALING & CONTRACTING COORDIN)
(980) 729-5200
Entity
Organization
Contact information
Practice address
1454 FERN CREEK DRIVE, STATESVILLE, NC 28625
(980) 223-2607
(980) 223-6064
Mailing address
PO BOX 530172, ATLANTA, GA 30353-0172
(980) 729-5200
(704) 943-0593
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9277
NC
Other
Enumeration date
01/22/2015
Last updated
07/09/2021
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