Provider Demographics
NPI:1710197728
Name:THORNTON, BENJAMIN R (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:R
Last Name:THORNTON
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Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
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Mailing Address - Street 1:1800 VALLEY RIVER DR
Mailing Address - Street 2:SUITE #201
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6714
Mailing Address - Country:US
Mailing Address - Phone:541-686-1732
Mailing Address - Fax:541-686-1537
Practice Address - Street 1:1800 VALLEY RIVER DR
Practice Address - Street 2:SUITE #201
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6714
Practice Address - Country:US
Practice Address - Phone:541-686-1732
Practice Address - Fax:541-686-1537
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR82881223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics