Provider Demographics
NPI:1083127237
Name:CHAD THORPE DDS PLC
Entity type:Organization
Organization Name:CHAD THORPE DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:T
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-467-9325
Mailing Address - Street 1:664 E MAIN ST STE F
Mailing Address - Street 2:PO BOX 777
Mailing Address - City:CENTREVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49032
Mailing Address - Country:US
Mailing Address - Phone:269-467-9325
Mailing Address - Fax:269-467-9095
Practice Address - Street 1:664 E MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MI
Practice Address - Zip Code:49032
Practice Address - Country:US
Practice Address - Phone:269-467-9325
Practice Address - Fax:269-467-9095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010209731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty