Provider Demographics
NPI:1710246277
Name:THORPE, TIFFANY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:THORPE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3872
Mailing Address - Country:US
Mailing Address - Phone:570-323-4500
Mailing Address - Fax:570-666-4163
Practice Address - Street 1:1750 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3872
Practice Address - Country:US
Practice Address - Phone:570-323-4500
Practice Address - Fax:570-666-4163
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0395011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice