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General NPI Number Information
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NPI Number | 1003897273
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Entity Type | Individual
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Provider Name | GARY M THOMPSON DMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 131 N MAIN ST
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City | STANTON
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State | KY
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Zip | 40380-2174
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Country | US
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Telephone | 606-663-2133
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Fax | 606-663-0699
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Provider Business Mailing Address
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Address Line | 889 BOONE CREEK RD
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City | STANTON
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State | KY
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Zip | 40380-9435
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Country | US
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Telephone | 606-663-2133
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Fax | 606-663-0699
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4473
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License Number State | KY
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