Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 2005 | MT |
N | 126800000X | Dental Assistant | 1057 | AK |
NPI | 1154389526 |
---|---|
Provider Name | Reed E Thompson |
First Address | Kalispell, MT 59901-2165 |
Second Address | Kalispell, MT 59901-2663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 22/07/2009 |