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General NPI Number Information
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NPI Number | 1386219707
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Entity Type | Individual
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Provider Name | TODD MATTHEW THURMAN DMD, FAGD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 2052 HARRIS PIKE # 54
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City | INDEPENDENCE
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State | KY
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Zip | 41051-7783
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Country | US
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Telephone | 859-898-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 328 CORNWALL DR
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City | FLORENCE
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State | KY
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Zip | 41042-9207
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Country | US
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Telephone | 502-435-2233
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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 | 30.026976
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10621
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License Number State | KY
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