MEDICARE: DR. DENNIS M THOMPSON DDS

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
1	1223P0300X	Periodontics	3695	CO

General Provider Information

NPI Number	:	1811981962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS M THOMPSON DDS

Provider Business Mailing Address
First Line	:	3626 E HIGHLANDS RANCH PKWY
Second Line	:	#107
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-7885
Country	:	US
Telephone Number	:	303-471-0841
Fax Number	:

Provider Business Practice Location Address
First Line	:	12477 TOPAZ VISTA WAY
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-8256
Country	:	US
Telephone Number	:	303-925-0571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	07/08/2007

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