Provider Demographics
NPI:1699987081
Name:THOMAS, CECELIA (DDS)
Entity type:Individual
Prefix:DR
First Name:CECELIA
Middle Name:
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 1:96 DAVIS RD
Mailing Address - Street 2:SUITE5
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3041
Mailing Address - Country:US
Mailing Address - Phone:925-254-0824
Mailing Address - Fax:
Practice Address - Street 1:1 BATES BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2800
Practice Address - Country:US
Practice Address - Phone:707-694-5349
Practice Address - Fax:925-354-0831
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35176122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist