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General NPI Number Information
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NPI Number | 1780316349
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Entity Type | Individual
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Provider Name | CHASE J THORPE DMD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 710 23RD ST UNIT 300
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City | CANYON
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State | TX
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Zip | 79015-4654
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Country | US
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Telephone | 806-421-0922
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Fax |
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Provider Business Mailing Address
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Address Line | 9977 N WELLINGTON CT
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City | HIGHLAND
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State | UT
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Zip | 84003-3469
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Country | US
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Telephone | 801-376-2917
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38693
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38693
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License Number State | TX
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