Provider Demographics
NPI:1538387832
Name:THERRIEN, THOMAS (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:THERRIEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 NARRAGANSETT DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1924
Mailing Address - Country:US
Mailing Address - Phone:856-667-1951
Mailing Address - Fax:
Practice Address - Street 1:3156 KENSINGTON AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2400
Practice Address - Country:US
Practice Address - Phone:215-831-1100
Practice Address - Fax:215-831-0500
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027324L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice