Provider Demographics
NPI:1831284496
Name:THOMPSON, STEVE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
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 1:2150 W POPLAR AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-0625
Mailing Address - Country:US
Mailing Address - Phone:901-854-4426
Mailing Address - Fax:901-854-8063
Practice Address - Street 1:2150 W POPLAR AVE
Practice Address - Street 2:106
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0625
Practice Address - Country:US
Practice Address - Phone:901-854-4426
Practice Address - Fax:901-854-8063
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice