Provider Demographics
NPI:1104248293
Name:THOMAS F GESSEL PLLC
Entity type:Organization
Organization Name:THOMAS F GESSEL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:GESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-503-1023
Mailing Address - Street 1:1628 S MILDRED ST STE 201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1629
Mailing Address - Country:US
Mailing Address - Phone:253-503-1023
Mailing Address - Fax:253-448-2995
Practice Address - Street 1:1628 S MILDRED ST STE 201
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1629
Practice Address - Country:US
Practice Address - Phone:253-503-1023
Practice Address - Fax:253-448-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 601753361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty