Provider Demographics
NPI:1063769453
Name:HUNTER THOMAS, DDS, PA
Entity type:Organization
Organization Name:HUNTER THOMAS, DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-445-4040
Mailing Address - Street 1:508 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:BULL SHOALS
Mailing Address - State:AR
Mailing Address - Zip Code:72619
Mailing Address - Country:US
Mailing Address - Phone:870-445-4040
Mailing Address - Fax:870-445-3216
Practice Address - Street 1:508 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:BULL SHOALS
Practice Address - State:AR
Practice Address - Zip Code:72619
Practice Address - Country:US
Practice Address - Phone:870-445-4040
Practice Address - Fax:870-445-3216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty