Individual
DR. THOMAS G OLDAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
4640 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 432-2813
Mailing address
4640 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 432-2813
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12007721
IN
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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