Organization
DR. KENNETH THOMPSON D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R. THOMPSON D.D.S. (DENTIST/OWNER)
(479) 273-5345
Entity
Organization
Contact information
Practice address
2701 SE G ST, SUITE 9, BENTONVILLE, AR 72712-3740
(479) 273-5345
(479) 273-5335
Mailing address
2701 SE G ST, SUITE 9, BENTONVILLE, AR 72712-3740
(479) 273-5345
(479) 273-5335
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1888
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101101608
—
AR
01
—
1437286861
NPI TYPE 1
AR
Enumeration date
12/29/2008
Last updated
12/29/2008
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