Provider Demographics
NPI:1336252873
Name:WORCESTER, THOMAS CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CRAIG
Last Name:WORCESTER
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 1:2323 NE 26TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:954-941-2606
Mailing Address - Fax:954-941-9186
Practice Address - Street 1:2323 NE 26TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-941-2606
Practice Address - Fax:954-941-9186
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 8639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist