Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 61455 | KS |
NPI | 1619454600 |
---|---|
Provider Name | Dr. Christine Marie Thomas |
First Address | Hays, KS 67601-2047 |
Second Address | Hays, KS 67601-3613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2018 |
Last Update Date | 28/12/2018 |