Provider Demographics
NPI:1093826604
Name:THORNTON, ROBERT P (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:THORNTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 45TH ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2906
Mailing Address - Country:US
Mailing Address - Phone:219-924-1942
Mailing Address - Fax:219-924-1190
Practice Address - Street 1:2839 45TH ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2906
Practice Address - Country:US
Practice Address - Phone:219-924-1942
Practice Address - Fax:219-924-1190
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN67901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice