Individual ProviderThomas C DewittDentistDental ProvidersPractice Address2306 S Broadway St, Alexandria, MN 56308-3459(320) 762-5216PECOS EnrollmentBased on the most recent information from CMS, provider Thomas C Dewitt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1316067028Provider TypeIndividualFull NameDewitt, Thomas CTitleDr.GenderMaleSole ProprietorNoEnumeration Date3/29/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address2306 S Broadway St, Alexandria, MN 56308-3459Phone(320) 762-5216FaxUnlisted FaxMailing LocationMailing Address8650 E Lake Carlos Dr NE, Carlos, MN 56319-8119Phone(320) 762-5216FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense9915Minnesota