Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | GA8010 | GA |
NPI | 1043374598 |
---|---|
Provider Name | Dr. Thomas E Day |
First Address | Augusta, GA 30909-1824 |
Second Address | Augusta, GA 30909-1824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |