Provider Demographics
NPI:1902980402
Name:LIGON, THOMAS ALLEN III (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLEN
Last Name:LIGON
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1121 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5101
Mailing Address - Country:US
Mailing Address - Phone:662-236-5300
Mailing Address - Fax:662-236-5580
Practice Address - Street 1:1121 MIMOSA DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5101
Practice Address - Country:US
Practice Address - Phone:662-236-5300
Practice Address - Fax:662-236-5580
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSOS-367-031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery