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Individual

MICHAEL R THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1511 CARLSON STREET, MARSHALL, MN 56258-2605
(507) 532-3353
(507) 532-3482
Mailing address
1511 CARLSON ST, MARSHALL, MN 56258-2626
(507) 532-3353
(507) 532-3482

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10593
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0B12TH
BLUE CROSS BLUE SHIELD IN
MN
05
834222900
MN
01
836189
UNITED CONCORDIA INS
Enumeration date
07/21/2006
Last updated
04/25/2013
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