Provider Demographics
NPI:1346397270
Name:THOMPSON, STEVEN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
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 1:42 PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-1129
Mailing Address - Country:US
Mailing Address - Phone:585-638-5435
Mailing Address - Fax:585-638-7798
Practice Address - Street 1:42 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-1129
Practice Address - Country:US
Practice Address - Phone:585-638-5435
Practice Address - Fax:585-638-7798
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0380541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice