Provider Demographics
NPI:1043285067
Name:VINCE, THOMAS SCOTT (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SCOTT
Last Name:VINCE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 TOWNE SQUARE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5729
Mailing Address - Country:US
Mailing Address - Phone:724-836-2375
Mailing Address - Fax:724-836-1424
Practice Address - Street 1:985 TOWNE SQUARE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5729
Practice Address - Country:US
Practice Address - Phone:724-836-2375
Practice Address - Fax:724-836-1424
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO27537L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS027537LOtherSTATE DENTAL LICENSE