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General NPI Number Information
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NPI Number | 1699015685
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Entity Type | Organization
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Legal Business Name | KENT THIGPEN, DDS, PC
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 601 N WALNUT ST
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City | JEFFERSON
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State | TX
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Zip | 75657-1851
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Country | US
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Telephone | 903-665-3914
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Fax | 903-665-3921
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Provider Business Mailing Address
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Address Line | 601 N WALNUT ST
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City | JEFFERSON
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State | TX
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Zip | 75657-1851
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Country | US
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Telephone | 903-665-3914
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Fax | 903-665-3921
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RAYFORD KENT THIGPEN
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Credential | D.D.S.
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Telephone | 903-665-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14998
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License Number State | TX
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