Provider Demographics
NPI:1457960577
Name:THURMONT FAMILY DENTISTRY
Entity Type:Organization
Organization Name:THURMONT FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-271-2346
Mailing Address - Street 1:105 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THURMONT
Mailing Address - State:MD
Mailing Address - Zip Code:21788-2009
Mailing Address - Country:US
Mailing Address - Phone:301-271-2346
Mailing Address - Fax:301-271-4412
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-2009
Practice Address - Country:US
Practice Address - Phone:301-271-2346
Practice Address - Fax:301-271-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental