Provider Demographics
NPI:1376716845
Name:THOMSON, STEVEN WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:THOMSON
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 1:825 EAST ST #121
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776
Mailing Address - Country:US
Mailing Address - Phone:530-666-3733
Mailing Address - Fax:530-666-3780
Practice Address - Street 1:825 EAST ST #121
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776
Practice Address - Country:US
Practice Address - Phone:530-666-3733
Practice Address - Fax:530-666-3780
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30483122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist