Provider Demographics
NPI:1386774180
Name:BROOKS, THOMAS E (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:BROOKS
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 1:1142 EXECUTIVE CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4570
Mailing Address - Country:US
Mailing Address - Phone:919-467-9651
Mailing Address - Fax:919-467-7849
Practice Address - Street 1:1142 EXECUTIVE CIR
Practice Address - Street 2:SUITE A
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4570
Practice Address - Country:US
Practice Address - Phone:919-467-9651
Practice Address - Fax:919-467-7849
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice