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General NPI Number Information
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NPI Number | 1417223090
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Entity Type | Organization
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Legal Business Name | RUSK, THORNTON DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 818 18TH STREET NW SUITE 200
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City | WASHINGTON
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State | DC
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Zip | 20006
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Country | US
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Telephone | 202-293-5805
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Fax | 202-293-7675
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Provider Business Mailing Address
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Address Line | 818 18TH STREET NW SUITE 200
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City | WASHINGTON
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State | DC
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Zip | 20006
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Country | US
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Telephone | 202-293-5805
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Fax | 202-293-7675
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. WILLIAM NORMAN THORNTON IV
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Credential | DDS
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Telephone | 202-293-5805
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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 | 5154
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License Number State | DC
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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 | 1000485
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License Number State | DC
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