Provider Demographics
NPI:1922032010
Name:THOMPSON, ROBERT K JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 STAGECOACH WAY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1722
Mailing Address - Country:US
Mailing Address - Phone:781-383-1450
Mailing Address - Fax:
Practice Address - Street 1:4 STAGECOACH WAY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1722
Practice Address - Country:US
Practice Address - Phone:781-383-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA168261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice