Individual
DR. THOMAS MICHAEL GOTSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12266 DEPAUL DR, STE 325, BRIDGETON, MO 63044
(314) 291-9000
(314) 291-0590
Mailing address
12266 DEPAUL DR, STE 325, BRIDGETON, MO 63044
(314) 291-9000
(314) 291-0590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE015476
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6473770001
PTAN
—
Enumeration date
09/07/2006
Last updated
02/03/2011
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