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NPI Code Detail

MEDICARE: WILLIAM CODY THORNTON DMD

MEDICARE: WILLIAM CODY THORNTON DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1700716479
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM CODY THORNTON DMD
Provider Business Mailing Address
First Line : 2649 BIG SUR AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32065-8659
Country : US
Telephone Number : 904-881-0668
Fax Number :
Provider Business Practice Location Address
First Line : 2845 UNIVERSITY BLVD W
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-2116
Country : US
Telephone Number : 904-293-2520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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