Individual
DR. THANE HEPWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3 E CENTER ST, SUGAR CITY, ID 83448-1247
(208) 656-2000
(208) 464-9002
Mailing address
PO BOX 57, SUGAR CITY, ID 83448-0057
(208) 656-2000
(208) 464-9002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D1059
SD
122300000X
Dentist
Primary
D4717
ID
Other
Enumeration date
07/01/2014
Last updated
07/29/2024
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