Provider Demographics
NPI:1629201124
Name:COTTON, THOMAS SMITH (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SMITH
Last Name:COTTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 MCCANN RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-3852
Mailing Address - Country:US
Mailing Address - Phone:903-753-2988
Mailing Address - Fax:903-753-6545
Practice Address - Street 1:1405 MCCANN RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3852
Practice Address - Country:US
Practice Address - Phone:903-753-2988
Practice Address - Fax:903-753-6545
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12275122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist