Provider Demographics
NPI:1366659302
Name:THOUSAND, JOHN W III (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:THOUSAND
Suffix:III
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 1:16981 E QUINCY AVE
Mailing Address - Street 2:#D1-D3
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2769
Mailing Address - Country:US
Mailing Address - Phone:303-617-8400
Mailing Address - Fax:303-617-3516
Practice Address - Street 1:16981 E QUINCY AVE
Practice Address - Street 2:#D1-D3
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2769
Practice Address - Country:US
Practice Address - Phone:303-617-8400
Practice Address - Fax:303-617-3516
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist