| Brent Thomas Dmd Pa | |
|
1805 Mission 66 Vicksburg MS 39180-3709 | |
| (601) 638-2361 | |
| (601) 634-0864 |
| Full Name | Brent Thomas Dmd Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1805 Mission 66, Vicksburg, Mississippi |
| Authorized Official Name and Position | Charles Brent Thomas (DENTIST) |
| Authorized Official Contact | 6016382361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Thomas Dmd Pa 1805 Mission 66 Vicksburg MS 39180-3709 Ph: (601) 638-2361 | Brent Thomas Dmd Pa 1805 Mission 66 Vicksburg MS 39180-3709 Ph: (601) 638-2361 |
| NPI Number | 1306190285 |
|---|---|
| Provider Enumeration Date | 10/31/2012 |
| Last Update Date | 10/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306190285 | NPI | - | NPPES |
| 1649492695 | Other | MS | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 195381 (Mississippi) | Primary |
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Margo R Marveggio Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Mission 66, Vicksburg, MS 39183 Phone: 601-636-6081 | |
Vicksburg Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
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