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NPI Code Detail

MEDICARE: DR. JACK FINLEY THOMPSON SR. D.D.S.

MEDICARE:  DR. JACK FINLEY THOMPSON SR. D.D.S.
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
11223G0001XGeneral Practice Dentistry3792VA

General Provider Information

NPI Number : 1952319295
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACK FINLEY THOMPSON SR. D.D.S.
Provider Business Mailing Address
First Line : 402 N MAIN ST
Second Line : PO BOX 445
City : GORDONSVILLE
State : VA
Zip : 22942-0445
Country : US
Telephone Number : 540-832-3141
Fax Number : 540-832-5754
Provider Business Practice Location Address
First Line : 402 NORTH MAIN ST.
Second Line : N/A
City : GORDONSVILLE
State : VA
Zip : 22942-0445
Country : US
Telephone Number : 540-832-3141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JACK FINLEY THOMPSON SR. D.D.S.” Practice Location

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