Provider Demographics
NPI:1336272442
Name:THOMPSON, VERONICA ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:ANNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7529
Mailing Address - Country:US
Mailing Address - Phone:727-734-9796
Mailing Address - Fax:
Practice Address - Street 1:5210 CREEKWOOD BLVD E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-8916
Practice Address - Country:US
Practice Address - Phone:941-755-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice