Individual
DR. MICHAEL JOHN THARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
101 WEST THIRD STREET, WEST LIBERTY, IA 52776-1405
(319) 627-2328
Mailing address
101 WEST THIRD STREET, WEST LIBERTY, IA 52776-1405
(319) 627-2328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5976
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012005
—
IA
Enumeration date
10/03/2006
Last updated
07/08/2007
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