Provider Demographics
NPI:1548376858
Name:ERNEST R THOMPSON DMD PC
Entity type:Organization
Organization Name:ERNEST R THOMPSON DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-649-5900
Mailing Address - Street 1:3895 SW 185TH AVE
Mailing Address - Street 2:#130
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-1573
Mailing Address - Country:US
Mailing Address - Phone:503-649-5900
Mailing Address - Fax:503-649-9047
Practice Address - Street 1:3895 SW 185TH AVE
Practice Address - Street 2:#130
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97007-1573
Practice Address - Country:US
Practice Address - Phone:503-649-5900
Practice Address - Fax:503-649-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD6115122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty