MEDICARE: DR. STANLEY P. TOMPKINS 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
1	1223G0001X	General Practice Dentistry	0401004504	VA

General Provider Information

NPI Number	:	1750616298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY P. TOMPKINS DDS

Provider Business Mailing Address
First Line	:	5830 TRUCKER STREET
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703
Country	:	US
Telephone Number	:	757-484-8595
Fax Number	:	757-686-5600

Provider Business Practice Location Address
First Line	:	5830 TRUCKER STREET
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703
Country	:	US
Telephone Number	:	757-484-8595
Fax Number	:	757-686-5600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2009
Last Update Date	:	10/15/2009

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