Individual
DERIC D THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
707 W EAU GALLIE BLVD, MELBOURNE, FL 32935-5958
(322) 727-3223
(321) 727-9448
Mailing address
63 FOREST EDGE DR, SAINT JOHNS, FL 32259-7311
(404) 759-4507
(386) 438-5812
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN24343
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
ME172693
FL
Other
Enumeration date
02/25/2019
Last updated
07/09/2025
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