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General NPI Number Information
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NPI Number | 1659619500
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Entity Type | Organization
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Legal Business Name | STEVEN C THARP DDS PC
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 10171 W LINCOLN HWY
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City | FRANKFORT
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State | IL
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Zip | 60423-1274
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Country | US
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Telephone | 815-712-6521
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Fax |
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Provider Business Mailing Address
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Address Line | 10S267 KAYE LN
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City | WILLOWBROOK
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State | IL
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Zip | 60527-6019
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Country | US
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Telephone | 815-712-6521
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN CASIMIR THARP
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Credential | DDS
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Telephone | 815-712-6521
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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 | 019.028356
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License Number State | IL
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