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General NPI Number Information
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NPI Number | 1992970503
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Entity Type | Organization
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Legal Business Name | GEFFREY W. THOMPSON
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 1322 W KATHLEEN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-7365
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Country | US
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Telephone | 208-667-7461
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Fax | 208-765-5753
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Provider Business Mailing Address
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Address Line | 1322 W KATHLEEN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-7365
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Country | US
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Telephone | 208-667-7461
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Fax | 208-765-5753
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEFFREY W. THOMPSON
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Credential | D.M.D.
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Telephone | 208-667-7461
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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 | D-1655
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License Number State | ID
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