Provider Demographics
NPI:1720243652
Name:DALTON, THOMAS J (RPA, RT(R))
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:DALTON
Suffix:
Gender:M
Credentials:RPA, RT(R)
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Mailing Address - Street 1:PO BOX 615
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-0615
Mailing Address - Country:US
Mailing Address - Phone:978-266-2676
Mailing Address - Fax:978-266-2680
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-946-8103
Practice Address - Fax:978-946-8067
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA04MA1102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant