Provider Demographics
NPI:1639417520
Name:THARP DENTAL, LTD.
Entity Type:Organization
Organization Name:THARP DENTAL, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-806-1010
Mailing Address - Street 1:10171 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1274
Mailing Address - Country:US
Mailing Address - Phone:815-806-1010
Mailing Address - Fax:815-806-1020
Practice Address - Street 1:10171 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1274
Practice Address - Country:US
Practice Address - Phone:815-806-1010
Practice Address - Fax:815-806-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty