Organization
DAVID E THOME DDS PLLC L1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCENDA HARRIS (CREDENTIALING AND CONTRACTING COORD)
(704) 361-9508
Entity
Organization
Contact information
Practice address
1454 FERN CREEK DRIVE, STATESVILLE, NC 28625
(980) 223-2607
Mailing address
8604 CLIFF CAMERON DR STE 170, CHARLOTTE, NC 28269-8508
(704) 361-9508
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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