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NPI Code Detail

MEDICARE: THOMPSON AND MOORE, D.D.S., P.C.

MEDICARE: THOMPSON AND MOORE, D.D.S., P.C.
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 Dentistry013916MO
21223G0001XGeneral Practice Dentistry013954MO

General Provider Information

NPI Number : 1700188703
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMPSON AND MOORE, D.D.S., P.C.
Provider Business Mailing Address
First Line : 1319 CAULKS HILL RD
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63304-6863
Country : US
Telephone Number : 636-441-3430
Fax Number : 636-441-5987
Provider Business Practice Location Address
First Line : 1319 CAULKS HILL RD
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63304-6863
Country : US
Telephone Number : 636-441-3430
Fax Number : 636-441-5987
Authorized Official
Title or Position : TRES/SEC
Name : DR. ROBERT WELDON THOMPSON
Credential : D.D.S.
Telephone Number : 636-441-3430
Provider Enumeration Date : 11/23/2010
Last Update Date : 11/23/2010

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