Provider Demographics
NPI:1801938618
Name:GEORGE V. THOMAS, D.D.S. & SETH M. GREENFIELD, D.D.S., INC.
Entity type:Organization
Organization Name:GEORGE V. THOMAS, D.D.S. & SETH M. GREENFIELD, D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-357-1222
Mailing Address - Street 1:9510 DIAMOND CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1876
Mailing Address - Country:US
Mailing Address - Phone:440-357-1222
Mailing Address - Fax:440-357-0418
Practice Address - Street 1:9510 DIAMOND CENTRE DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-1876
Practice Address - Country:US
Practice Address - Phone:440-357-1222
Practice Address - Fax:440-357-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0888320Medicaid