Individual
DR. STUART M THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5685 S 1475 E STE 3A, SOUTH OGDEN, UT 84403-4598
(801) 479-9220
Mailing address
887 COUNTRY LN, FARMINGTON, UT 84025-4727
(801) 589-0197
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
143612
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
803747
UNITED CONCORDIA ID
UT
01
—
943282345
TAX ID
UT
Enumeration date
03/25/2006
Last updated
09/06/2012
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