Provider Demographics
NPI:1932260460
Name:DRS. THORNTON, KOONTZ, AND SPALDING, PLC
Entity Type:Organization
Organization Name:DRS. THORNTON, KOONTZ, AND SPALDING, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:757-562-2165
Mailing Address - Street 1:1301 ARMORY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-2419
Mailing Address - Country:US
Mailing Address - Phone:757-562-2165
Mailing Address - Fax:757-516-8240
Practice Address - Street 1:1301 ARMORY DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-2419
Practice Address - Country:US
Practice Address - Phone:757-562-2165
Practice Address - Fax:757-516-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010045031223G0001X
VA04010072751223G0001X
VA04010069091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA235046OtherANTHEM PROVIDER NUMBER