Individual
DR. JUSTIN EUGENE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4590 STROM THURMOND BLVD, COLUMBIA, SC 29207-5305
(803) 751-5378
Mailing address
127 PONTE VEDRA DR, COLUMBIA, SC 29206-1430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041752
PA
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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