Provider Demographics
NPI:1811911324
Name:THORNTON, WILLIAM NORMAN IV (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NORMAN
Last Name:THORNTON
Suffix:IV
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 1:1619 12TH ST NW
Mailing Address - Street 2:UNIT B
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4301
Mailing Address - Country:US
Mailing Address - Phone:202-230-7825
Mailing Address - Fax:
Practice Address - Street 1:818 18TH ST NW
Practice Address - Street 2:STE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3513
Practice Address - Country:US
Practice Address - Phone:202-293-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist