Provider Demographics
NPI:1083693600
Name:THORNTON, WILLIAM E (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
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 1:6501 BLANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216
Mailing Address - Country:US
Mailing Address - Phone:210-341-7264
Mailing Address - Fax:210-341-2022
Practice Address - Street 1:6501 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6627
Practice Address - Country:US
Practice Address - Phone:210-341-7264
Practice Address - Fax:210-341-2022
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1207540-05Medicaid
TX1207540-08Medicaid
731009960006OtherTRICARE
80W702OtherBCBS
TX1207540-10Medicaid
838355OtherUNITED CONCORDIA
TX1207540-04Medicaid
00N96AOtherGROUP BCBS
TX1207540-07Medicaid
TX1207540-06Medicaid
TX1207540-09Medicaid
TX1207540-05Medicaid
80W702OtherBCBS
T16283Medicare UPIN
TX1207540-09Medicaid