Brent Thomas DMD PA

Organization Active NPI General Practice Dentistry · Vicksburg, MS

NPI 1306190285 · NPPES record last updated Oct 31, 2012

Key facts

NPI
1306190285
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
195381 (MS)
Legal business name
BRENT THOMAS DMD PA
Practice address
1805 Mission 66
Vicksburg, MS 39180-3709
Phone
(601) 638-2361
Fax
(601) 634-0864
NPI assigned
Oct 31, 2012
Organization subpart
No

Authorized official

Name
Dr. Charles Brent Thomas, DMD
Title
Dentist
Phone
(601) 638-2361

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 195381 MS Yes

Addresses

Primary practice location

1805 Mission 66
Vicksburg, MS 39180-3709

Mailing address

1805 Mission 66
Vicksburg, MS 39180-3709
Phone (601) 638-2361

Other identifiers

IdentifierTypeStateIssuer
1649492695OtherMSNPI INDIVIDUAL

Other providers in Vicksburg, MS

All providers in Vicksburg, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.