Provider Demographics
NPI:1538183777
Name:THURM, MYRON JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:MYRON
Middle Name:JAY
Last Name:THURM
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 1:850 KEENE LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2211
Mailing Address - Country:US
Mailing Address - Phone:516-569-5010
Mailing Address - Fax:516-569-6125
Practice Address - Street 1:850 KEENE LN
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2211
Practice Address - Country:US
Practice Address - Phone:516-569-5010
Practice Address - Fax:516-569-6125
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist