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General NPI Number Information
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NPI Number | 1407165335
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Entity Type | Organization
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Legal Business Name | THORNE DENT CORPORATION
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 144 W LOS ANGELES AVE STE. 114
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City | MOORPARK
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State | CA
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Zip | 93021-1898
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Country | US
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Telephone | 805-553-1980
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Fax | 805-553-1981
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Provider Business Mailing Address
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Address Line | 144 W LOS ANGELES AVE STE. 114
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City | MOORPARK
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State | CA
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Zip | 93021-1898
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Country | US
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Telephone | 805-553-1980
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Fax | 805-553-1981
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARLA THORNE
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Credential |
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Telephone | 805-553-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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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 |
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License Number State |
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