Thomas H Boreman, D.D.S.
Individual provider Active NPI General Practice Dentistry · Smithville, OH
NPI 1366474017 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366474017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30-014922 (OH)
- Practice address
- 157 S Milton St
Smithville, OH 44677-9601 - Phone
- (330) 669-2071
- Fax
- (330) 669-2988
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-014922 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-014922 | OH | Yes |
Addresses
Primary practice location
157 S Milton St
Smithville, OH 44677-9601
Mailing address
157 S Milton St
Smithville, OH 44677-9601
Phone (330) 669-2071
Other providers in Smithville, OH
All providers in Smithville, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.