Individual
DR. CLARENCE L. THOMAS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
442 N DETROIT ST, XENIA, OH 45385-2234
(937) 372-4454
(937) 372-5994
Mailing address
PO BOX 870, XENIA, OH 45385-0870
(937) 372-4454
(937) 372-5994
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19941
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264351
—
OH
Enumeration date
07/26/2006
Last updated
07/09/2007
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