Provider Demographics
NPI:1932477528
Name:THATCHER-WILSON, DEBORAH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:THATCHER-WILSON
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 1:7130 MINSTREL WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5201
Mailing Address - Country:US
Mailing Address - Phone:410-381-4701
Mailing Address - Fax:
Practice Address - Street 1:7130 MINSTREL WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5201
Practice Address - Country:US
Practice Address - Phone:410-381-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist