Provider Demographics
NPI:1043321243
Name:CARCHIDI, THOMAS PAUL ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL ANTHONY
Last Name:CARCHIDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 C MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-0221
Mailing Address - Country:US
Mailing Address - Phone:508-533-6400
Mailing Address - Fax:508-533-6400
Practice Address - Street 1:89 C MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-0221
Practice Address - Country:US
Practice Address - Phone:508-533-6400
Practice Address - Fax:508-533-6400
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16619122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist