Provider Demographics
NPI:1003162231
Name:THORNE, GAYNE ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAYNE
Middle Name:ROBERT
Last Name:THORNE
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 1:3416 VALLE VERDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-255-4000
Mailing Address - Fax:707-255-4542
Practice Address - Street 1:3416 VALLE VERDE DRIVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-255-4000
Practice Address - Fax:707-255-4542
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA169991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice