Provider Demographics
NPI:1750633210
Name:THOMPSON, MATTSON CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTSON
Middle Name:CHRISTOPHER
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 1:2308A BELMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212
Mailing Address - Country:US
Mailing Address - Phone:865-567-9113
Mailing Address - Fax:
Practice Address - Street 1:1754 S RUTHERFORD BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-0721
Practice Address - Country:US
Practice Address - Phone:615-849-1292
Practice Address - Fax:615-849-1293
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000009506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist