Organization
JENNIFER R THORNE PA
Active
Other names
Liberty Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER R THORNE DDS (OWNER)
(817) 281-4300
Entity
Organization
Contact information
Practice address
8300 PRECINCT LINE RD STE 100, COLLEYVILLE, TX 76034-8242
(817) 281-4300
Mailing address
8300 PRECINCT LINE RD STE 100, COLLEYVILLE, TX 76034-8242
(817) 281-4300
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023149374
—
TX
Enumeration date
10/24/2018
Last updated
10/24/2018
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