Provider Demographics
NPI:1821172628
Name:THURMON, HADLEY KATHRYN (DDS)
Entity Type:Individual
Prefix:
First Name:HADLEY
Middle Name:KATHRYN
Last Name:THURMON
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 1:12454 YORK ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2741
Mailing Address - Country:US
Mailing Address - Phone:720-872-2892
Mailing Address - Fax:720-872-2894
Practice Address - Street 1:12454 YORK ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2741
Practice Address - Country:US
Practice Address - Phone:720-872-2892
Practice Address - Fax:720-872-2894
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87241223G0001X
MI180811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice