Individual
DR. JONATHON VAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
322 SE 11TH ST, ANADARKO, OK 73005-4446
(405) 247-7676
(405) 247-1153
Mailing address
PO BOX 338, ANADARKO, OK 73005-0338
(405) 247-7676
(405) 247-1153
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5295
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091680A
—
OK
Enumeration date
08/13/2009
Last updated
12/05/2012
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