Provider Demographics
NPI:1003998378
Name:ANDREW LEE THOMPSON DMD PC & ASSOC.
Entity Type:Organization
Organization Name:ANDREW LEE THOMPSON DMD PC & ASSOC.
Other - Org Name:NORTH PLAINS TENDER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-647-0055
Mailing Address - Street 1:10395 NW GLENCOE RD
Mailing Address - Street 2:STE # 100
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133
Mailing Address - Country:US
Mailing Address - Phone:503-647-0055
Mailing Address - Fax:503-647-0033
Practice Address - Street 1:10395 NW GLENCOE RD
Practice Address - Street 2:STE # 100
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133
Practice Address - Country:US
Practice Address - Phone:503-647-0055
Practice Address - Fax:503-647-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty