Provider Demographics
NPI:1063533297
Name:TENNEY, THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:TENNEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 CROSS TIMBERS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1392
Mailing Address - Country:US
Mailing Address - Phone:469-830-7525
Mailing Address - Fax:469-830-7524
Practice Address - Street 1:765 CROSS TIMBERS RD STE 105
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1392
Practice Address - Country:US
Practice Address - Phone:469-830-7525
Practice Address - Fax:469-830-7524
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32201223G0001X
TX275051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice