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Provider Information for 1447267190



DR. BENNETT ALLEN THOMAS DDS

Gender: MALE

Individual NPI: 1447267190

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1447267190
Enumeration Date 2006-08-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1300 CEDAR RD
CHESAPEAKE, VA 23322
United States

Phone: 757-548-3238 | Fax: 757-547-0679
View Map External Link
Primary Practice Address 1300 CEDAR RD
CHESAPEAKE, VA 23322
United States

Phone: 757-548-3238 | Fax: 757-547-0679
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice VA 0401007166