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Individual

DR. THOMAS H LIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
10155 WASHINGTON AVE, STURTEVANT, WI 53177-1645
(262) 884-3011
Mailing address
163 E LOUIS AVE, LAKE FOREST, IL 60045-2940
(618) 789-0886

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019027629
IL
122300000X
Dentist
25321
TX
122300000X
Dentist
DE 60187365
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1000999
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
10301
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019027629
ILLINOIS DFPR
IL
01
10301
COLORADO STATE BOARD OF DENTISTRY
CO
Enumeration date
03/28/2008
Last updated
03/10/2020
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