Provider Demographics
NPI:1699015685
Name:KENT THIGPEN, DDS, PC
Entity type:Organization
Organization Name:KENT THIGPEN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYFORD
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-665-3914
Mailing Address - Street 1:601 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-1851
Mailing Address - Country:US
Mailing Address - Phone:903-665-3914
Mailing Address - Fax:903-665-3921
Practice Address - Street 1:601 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:TX
Practice Address - Zip Code:75657-1851
Practice Address - Country:US
Practice Address - Phone:903-665-3914
Practice Address - Fax:903-665-3921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14998122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty