Provider Demographics
NPI:1003237421
Name:MICHAEL P THOMPSON DDS PLLC
Entity Type:Organization
Organization Name:MICHAEL P THOMPSON DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-536-1100
Mailing Address - Street 1:111 W. WIGWAM BLVD.
Mailing Address - Street 2:STE. B
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4901
Mailing Address - Country:US
Mailing Address - Phone:623-536-1100
Mailing Address - Fax:623-536-1074
Practice Address - Street 1:111 W. WIGWAM BLVD.
Practice Address - Street 2:STE. B
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4901
Practice Address - Country:US
Practice Address - Phone:623-536-1100
Practice Address - Fax:623-536-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0081741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty