Basic Information
| Provider Information | |||||||||
| NPI: | 1417501362 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORN | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | KARINA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS/MSD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9900 BROADWAY ST APT 1881 | ||||||||
| Address2: | |||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775847844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817795330 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1205 LAKE RD | ||||||||
| Address2: | |||||||||
| City: | LA MARQUE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775685205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4099388018 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2019 | ||||||||
| LastUpdateDate: | 07/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0700X | 35567 | TX | Y | Dental Providers | Dentist | Prosthodontics |
No ID Information.