Thomas J Dietrich
Oral and Maxillofacial Surgeon Oral and Maxillofacial Pathology
4774 Munson St Nw Suite 102
Canton
, Ohio 44718-3634
Thomas J Dietrich
Oral and Maxillofacial Surgeon Oral and Maxillofacial Pathology
4774 Munson St Nw Suite 102
Canton
, Ohio 44718-3634
(330) 494-6630
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About
Features
Specialties
- Oral and Maxillofacial Pathology
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Thomas J Dietrich
- 4774 Munson St Nw Suite 102
- Canton, OH
- Zip : 44718-3634
- Fax : (330) 494-6630
- Phone : (330) 494-6653
Second Address
- Thomas J Dietrich
- 4774 Munson St Nw Suite 102
- Canton, OH
- Zip : 44718-3634
- Fax : (330) 494-6630
- Phone : (330) 494-6653
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223P0106X | Oral and Maxillofacial Pathology | 21924 | OH |
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 21924 | OH |
National Provider Identifier
| NPI | 1841301942 |
|---|---|
| Provider Name | Thomas J Dietrich |
| First Address | Canton, OH 44718-3634 |
| Second Address | Canton, OH 44718-3634 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2006 |
| Last Update Date | 31/08/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.