Provider Demographics
NPI:1164528345
Name:THOMPSON, DONALD JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOSEPH
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 1:3602 SLIDE RD
Mailing Address - Street 2:SUITE 31D SECURITY PARK
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-2532
Mailing Address - Country:US
Mailing Address - Phone:806-793-3535
Mailing Address - Fax:806-281-0224
Practice Address - Street 1:3602 SLIDE RD
Practice Address - Street 2:SUITE 31D SECURITY PARK
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-2532
Practice Address - Country:US
Practice Address - Phone:806-793-3535
Practice Address - Fax:806-281-0224
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD13227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD13227OtherBCBS