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General NPI Number Information
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NPI Number | 1235650912
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Entity Type | Individual
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Provider Name | KATHRYN JANE THORSON DDS
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Gender | Female
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 2096 FORD PARKWAY
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City | SAINT PAUL
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State | MN
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Zip | 55116
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Country | US
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Telephone | 651-237-9913
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Fax |
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Provider Business Mailing Address
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Address Line | 10700 FRANCE AVE S STE 102
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3693
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Country | US
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Telephone | 847-903-1980
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D13806
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License Number State | MN
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