Provider Demographics
NPI:1952319295
Name:THOMPSON, JACK FINLEY SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:FINLEY
Last Name:THOMPSON
Suffix:SR
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 1:402 N MAIN ST
Mailing Address - Street 2:PO BOX 445
Mailing Address - City:GORDONSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22942-0445
Mailing Address - Country:US
Mailing Address - Phone:540-832-3141
Mailing Address - Fax:540-832-5754
Practice Address - Street 1:402 NORTH MAIN ST.
Practice Address - Street 2:N/A
Practice Address - City:GORDONSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22942-0445
Practice Address - Country:US
Practice Address - Phone:540-832-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA37921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice