Provider Demographics
NPI:1316910847
Name:D'AUGUSTA, THOMAS C (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:D'AUGUSTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 DRUMGOOLE RD E
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2008
Mailing Address - Country:US
Mailing Address - Phone:718-356-7885
Mailing Address - Fax:718-356-7943
Practice Address - Street 1:4 DRUMGOOLE RD E
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-2008
Practice Address - Country:US
Practice Address - Phone:718-356-7885
Practice Address - Fax:718-356-7943
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE378591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice