MEDICARE: DR. JAMES K THORNTON DMD

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	3835	SC

General Provider Information

NPI Number	:	1982726667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES K THORNTON DMD

Provider Business Mailing Address
First Line	:	1267 38TH AVE N UNIT 219
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	843-448-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	1267 38TH AVE N UNIT 219
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1313
Country	:	US
Telephone Number	:	843-448-3810
Fax Number	:

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	12/13/2010

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