Provider Demographics
NPI:1104998608
Name:LEY, THOMAS K (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K
Last Name:LEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:266 COVENTRY WAY
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9023
Mailing Address - Country:US
Mailing Address - Phone:317-877-5382
Mailing Address - Fax:317-257-9706
Practice Address - Street 1:6302 RUCKER RD
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4886
Practice Address - Country:US
Practice Address - Phone:317-257-9201
Practice Address - Fax:317-257-9706
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice