Organization
DAVID E THOMAS, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE CLARK (OFFICE MANAGER)
(208) 454-0473
Entity
Organization
Contact information
Practice address
616 S 10TH AVE, CALDWELL, ID 83605-4112
(208) 454-0473
(208) 454-2633
Mailing address
616 S 10TH AVE, CALDWELL, ID 83605-4112
(208) 454-0473
(208) 454-2633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1857
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002768200
—
ID
05
—
022470
—
OR
Enumeration date
06/10/2008
Last updated
06/10/2008
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