Provider Demographics
NPI:1366570848
Name:THURMAN, LON STANTON (DDS)
Entity type:Individual
Prefix:DR
First Name:LON
Middle Name:STANTON
Last Name:THURMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 ERIN PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3427
Mailing Address - Country:US
Mailing Address - Phone:719-532-0707
Mailing Address - Fax:719-532-0824
Practice Address - Street 1:6035 ERIN PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3427
Practice Address - Country:US
Practice Address - Phone:719-532-0707
Practice Address - Fax:719-532-0824
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist