Individual
DR. CHARLES JEFFERSON THOM JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22922 LOS ALISOS BLVD, STE J, MISSION VIEJO, CA 92691-2856
(949) 855-0176
(949) 837-0171
Mailing address
22922 LOS ALISOS BLVD, STE J, MISSION VIEJO, CA 92691-2856
(949) 855-0176
(949) 837-0171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30495
CA
Other
Enumeration date
10/13/2005
Last updated
07/08/2007
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