MEDICARE: DR. JENNIFER RHEANNE THORNE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	21836	TX
2	122300000X	Dentist	22031	TX

General Provider Information

NPI Number	:	1023149374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER RHEANNE THORNE D.D.S.

Provider Business Mailing Address
First Line	:	5959 WINTER PARK DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-5310
Country	:	US
Telephone Number	:	817-503-8000
Fax Number	:	817-503-8004

Provider Business Practice Location Address
First Line	:	6248 NORTH DAVIS BLVD.
Second Line	:	SUITE100
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180
Country	:	US
Telephone Number	:	817-503-8000
Fax Number	:	817-503-8004

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. JENNIFER RHEANNE THORNE D.D.S.” Practice Location

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