Provider Demographics
NPI:1902021520
Name:THURMOND, MOLLY M (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:M
Last Name:THURMOND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CODELL DR
Mailing Address - Street 2:STE 140
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1179
Mailing Address - Country:US
Mailing Address - Phone:859-523-9003
Mailing Address - Fax:859-523-9069
Practice Address - Street 1:80 CODELL DR
Practice Address - Street 2:STE 140
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1179
Practice Address - Country:US
Practice Address - Phone:859-523-9003
Practice Address - Fax:859-523-9069
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8452122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist