Provider Demographics
NPI:1043394984
Name:THORPE, KEVIN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:T
Last Name:THORPE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8229 CLAYTON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1155
Mailing Address - Country:US
Mailing Address - Phone:314-727-6110
Mailing Address - Fax:314-727-7558
Practice Address - Street 1:8229 CLAYTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1155
Practice Address - Country:US
Practice Address - Phone:314-727-6110
Practice Address - Fax:314-727-7558
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO132181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice