Provider Demographics
NPI:1386723757
Name:THOMAS, VILIJA B (DDS)
Entity type:Individual
Prefix:DR
First Name:VILIJA
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9947 N MACARTHUR BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4716
Mailing Address - Country:US
Mailing Address - Phone:972-401-8399
Mailing Address - Fax:972-869-0023
Practice Address - Street 1:9947 N MACARTHUR BLVD STE 125
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4716
Practice Address - Country:US
Practice Address - Phone:972-401-8399
Practice Address - Fax:972-869-0023
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice