Provider Demographics
NPI:1467575225
Name:THWIN, ANTHONY
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:THWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 N ALHAMBRA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-1372
Mailing Address - Country:US
Mailing Address - Phone:626-434-5877
Mailing Address - Fax:
Practice Address - Street 1:524 N ALHAMBRA AVE
Practice Address - Street 2:APT 2
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-1372
Practice Address - Country:US
Practice Address - Phone:626-434-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD461441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice