Individual
DR. BLAINE RANDY THORN II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2815 W LAKE HOUSTON PKWY, SUITE110, HUMBLE, TX 77339-5227
(281) 360-5645
(281) 360-8439
Mailing address
2815 W LAKE HOUSTON PKWY, SUITE110, HUMBLE, TX 77339-5227
(281) 360-5645
(281) 360-8439
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12079
TX
Other
Enumeration date
12/14/2005
Last updated
07/08/2007
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