Provider Demographics
NPI:1417223090
Name:RUSK, THORNTON DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RUSK, THORNTON DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-293-5805
Mailing Address - Street 1:818 18TH STREET NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-293-5805
Mailing Address - Fax:202-293-7675
Practice Address - Street 1:818 18TH STREET NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-293-5805
Practice Address - Fax:202-293-7675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10004851223G0001X
DC51541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty