Provider Demographics
NPI:1871683839
Name:ROWLAND, THOMAS S JR (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:ROWLAND
Suffix:JR
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 1:120 S 15TH AVE
Mailing Address - Street 2:PO BOX 4442
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4124
Mailing Address - Country:US
Mailing Address - Phone:601-426-2353
Mailing Address - Fax:
Practice Address - Street 1:120 S 15TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4124
Practice Address - Country:US
Practice Address - Phone:601-426-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1899-801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1899-80OtherMISSISSIPPI ST. LICENSE #