Individual
DR. THOMAS VINCENT BRISLIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4765 CARMEL MOUNTAIN RD STE 208, SAN DIEGO, CA 92130-6657
(858) 259-4765
Mailing address
100 E LEHIGH AVE, NAVY MEDICINE SUPPORT COMMAND, PHILADELPHIA, PA 19125-1012
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS038822
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS104296
CA
Other
Enumeration date
09/21/2011
Last updated
03/21/2023
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