Provider Demographics
NPI:1013656685
Name:THORNHILL, MATTHEW HUNTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HUNTER
Last Name:THORNHILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5331
Mailing Address - Country:US
Mailing Address - Phone:318-325-5423
Mailing Address - Fax:
Practice Address - Street 1:113 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5331
Practice Address - Country:US
Practice Address - Phone:318-325-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA73331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice