Provider Demographics
NPI:1013185461
Name:THOMPSON, EDWARD RALPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:RALPH
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HALF ACRE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1115
Mailing Address - Country:US
Mailing Address - Phone:732-521-4311
Mailing Address - Fax:
Practice Address - Street 1:6 HALF ACRE RD
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1115
Practice Address - Country:US
Practice Address - Phone:732-521-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI007443001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice