Provider Demographics
NPI:1679670236
Name:DENTISTRY FOR CHILDREN LAWRENCEBURG
Entity Type:Organization
Organization Name:DENTISTRY FOR CHILDREN LAWRENCEBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-766-6670
Mailing Address - Street 1:185 PROSSER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-4234
Mailing Address - Country:US
Mailing Address - Phone:931-766-6670
Mailing Address - Fax:
Practice Address - Street 1:185 PROSSER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4234
Practice Address - Country:US
Practice Address - Phone:931-766-6670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty