Provider Demographics
NPI:1992923494
Name:GORMAN, THOMAS FRANCIS (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:GORMAN
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 1:54 LAFAYETTE PL
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5430
Mailing Address - Country:US
Mailing Address - Phone:203-869-6129
Mailing Address - Fax:203-629-8485
Practice Address - Street 1:54 LAFAYETTE PL
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5430
Practice Address - Country:US
Practice Address - Phone:203-869-6129
Practice Address - Fax:203-629-8485
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT60241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice