Dance, Thomas Matthew

Dance, Thomas Matthew is an individual health care provider with primary practice located at 1027 W. Prairie Ave , Hayden ID 83835. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Dance, Thomas Matthew can be contacted via phone (208) 818-9432.

Contact Information

Primary practice address
1027 W. Prairie Ave Hayden ID 83835
Phone: (208) 818-9432
Fax: (208) 772-2213
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X D-4050 Idaho
Dental Providers / Pediatric Dentistry 1223P0221X D-4050-PD Idaho

Profile Details

NPI number 1518165430
LBN Legal business name Dance, Thomas Matthew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2007
Last updated Oct 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518165430 NPPES
Idaho MEDICAID 807729000

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