Provider Demographics
NPI:1912116336
Name:THOMPSON, NATHAN F (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:F
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 1:515 W 9TH ST
Mailing Address - Street 2:PO BOX 787
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3908
Mailing Address - Country:US
Mailing Address - Phone:402-463-0625
Mailing Address - Fax:402-463-2417
Practice Address - Street 1:515 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3908
Practice Address - Country:US
Practice Address - Phone:402-463-0625
Practice Address - Fax:402-463-2417
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6471122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist