Provider Demographics
NPI:1376098384
Name:DR. BRIAN THURMAN D. THURMAN, DDS, MS, INC
Entity Type:Organization
Organization Name:DR. BRIAN THURMAN D. THURMAN, DDS, MS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-439-0425
Mailing Address - Street 1:5479 N FRESNO ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8328
Mailing Address - Country:US
Mailing Address - Phone:559-439-0425
Mailing Address - Fax:
Practice Address - Street 1:5479 N FRESNO ST STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8328
Practice Address - Country:US
Practice Address - Phone:559-439-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty