Individual
DOMINIQUE DANIELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1221 RIDGEWOOD DR STE B, BOWLING GREEN, OH 43402-2785
(419) 352-2593
(844) 224-3880
Mailing address
1221 RIDGEWOOD DR STE B, BOWLING GREEN, OH 43402-2785
(419) 352-2593
(844) 224-3880
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30-026421
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
10/06/2021
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