Provider Demographics
NPI:1669423315
Name:WHITEHEAD, THORPE CLARKE (DDS)
Entity type:Individual
Prefix:DR
First Name:THORPE
Middle Name:CLARKE
Last Name:WHITEHEAD
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:U.S.A. DENTAC
Mailing Address - Street 2:646 SWIFT ROAD
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996
Mailing Address - Country:US
Mailing Address - Phone:845-938-3121
Mailing Address - Fax:
Practice Address - Street 1:SAUNDERS DENTAL CLINIC
Practice Address - Street 2:646 SWIFT CREEK ROAD
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996
Practice Address - Country:US
Practice Address - Phone:845-938-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA040100077951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics