Provider Demographics
NPI:1770744500
Name:THURBER, PHOEBE A (DDS)
Entity type:Individual
Prefix:DR
First Name:PHOEBE
Middle Name:A
Last Name:THURBER
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:PO BOX 1584
Mailing Address - Street 2:
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578-1584
Mailing Address - Country:US
Mailing Address - Phone:956-943-4166
Mailing Address - Fax:956-943-4168
Practice Address - Street 1:314 E QUEEN ISABELLA BLVD
Practice Address - Street 2:
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578-2407
Practice Address - Country:US
Practice Address - Phone:956-943-4166
Practice Address - Fax:956-943-4166
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice