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General NPI Number Information
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NPI Number | 1003865114
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Entity Type | Organization
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Legal Business Name | THORNLEY AND ASSOCIATES DDS PC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 17000 ROBBINS RD
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City | GRAND HAVEN
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State | MI
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Zip | 49417
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Country | US
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Telephone | 616-846-7360
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Fax | 616-846-2861
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Provider Business Mailing Address
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Address Line | 17000 ROBBINS RD
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City | GRAND HAVEN
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State | MI
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Zip | 49417
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Country | US
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Telephone | 616-846-7360
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Fax | 616-846-2861
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DENNIS A THORNLEY
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Credential | DDS
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Telephone | 616-846-7360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 01196401
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License Number State | MI
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