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General NPI Number Information
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NPI Number | 1902169469
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Entity Type | Individual
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Provider Name | PATRICK DES THOMPSON DMD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 07/12/2014
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Provider Practice Location Address
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Address Line | 3450 S HUALAPAI WAY
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City | LAS VEGAS
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State | NV
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Zip | 89117-7707
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Country | US
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Telephone | 702-871-6044
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Fax |
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Provider Business Mailing Address
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Address Line | 2917 GILMARY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89102-2079
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Country | US
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Telephone | 702-241-2018
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6490
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License Number State | NV
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