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NPI Code Detail

MEDICARE: DR. STEVAN HAYDEN THOMPSON DDS

MEDICARE: DR. STEVAN HAYDEN THOMPSON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN009114GA
2122300000XDentist4871NC
31223P0106XOral and Maxillofacial Pathology DentistryDN009114GA
41223P0106XOral and Maxillofacial Pathology Dentistry4871NC
51223S0112XOral and Maxillofacial Surgery (Dentist)DN009114GA
61223S0112XOral and Maxillofacial Surgery (Dentist)4871NC

General Provider Information

NPI Number : 1023088994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVAN HAYDEN THOMPSON DDS
Provider Business Mailing Address
First Line : 1851 MACGREGOR DOWNS RD
Second Line : OFFICE # 3111
City : GREENVILLE
State : NC
Zip : 27834-5925
Country : US
Telephone Number : 252-737-7071
Fax Number :
Provider Business Practice Location Address
First Line : 1851 MACGREGOR DOWNS RD
Second Line : OFFICE # 3111
City : GREENVILLE
State : NC
Zip : 27834-5925
Country : US
Telephone Number : 252-737-7071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 09/07/2012

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Directions to “ DR. STEVAN HAYDEN THOMPSON DDS” Practice Location

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