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General NPI Number Information
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NPI Number | 1417501362
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Entity Type | Individual
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Provider Name | ANNA KARINA THORN DDS/MSD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 1205 LAKE RD
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City | LA MARQUE
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State | TX
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Zip | 77568-5205
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Country | US
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Telephone | 409-938-8018
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 BROADWAY ST APT 1881
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City | PEARLAND
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State | TX
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Zip | 77584-7844
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Country | US
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Telephone | 281-779-5330
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 35567
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License Number State | TX
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