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General NPI Number Information
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NPI Number | 1639424120
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Entity Type | Organization
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Legal Business Name | THOMPSON FAMILY DENTISTRY
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 2816 VEACH RD SUITE 301A
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City | OWENSBORO
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State | KY
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Zip | 42303-6295
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Country | US
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Telephone | 270-683-1324
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Fax | 270-683-7541
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Provider Business Mailing Address
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Address Line | 2816 VEACH RD SUITE 301A
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City | OWENSBORO
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State | KY
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Zip | 42303-6295
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Country | US
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Telephone | 270-683-1324
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Fax | 270-683-7541
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. ANDREW EMBERGER THOMPSON
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Credential | D.M.D.
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Telephone | 270-683-1324
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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 | 8878
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License Number State | KY
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