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General NPI Number Information
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NPI Number | 1497764070
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Entity Type | Organization
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Legal Business Name | BRIAN L AND JENNIFER W THORNTON DDS PS
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 19170 8TH AVE NE
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City | POULSBO
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State | WA
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Zip | 98370-8773
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Country | US
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Telephone | 360-779-3633
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Fax | 360-779-6232
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Provider Business Mailing Address
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Address Line | 19170 8TH AVE NE
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City | POULSBO
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State | WA
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Zip | 98370-8773
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Country | US
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Telephone | 360-779-3633
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Fax | 360-779-6232
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER W THORNTON
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Credential | DDS
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Telephone | 360-799-3633
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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 | WA4364
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License Number State | WA
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