Provider Demographics
NPI:1417030198
Name:THOMPSON, JOSEPH HAROLD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HAROLD
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2812
Mailing Address - Country:US
Mailing Address - Phone:304-697-4110
Mailing Address - Fax:304-523-6021
Practice Address - Street 1:828 9TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2812
Practice Address - Country:US
Practice Address - Phone:304-697-4110
Practice Address - Fax:304-523-6021
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVD28231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics