Individual
DR. JACK B THIGPEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
10850 SHELDON RD, TAMPA, FL 33626-5117
(813) 926-5989
Mailing address
611 S DAKOTA AVE, TAMPA, FL 33606-2503
(863) 670-2849
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN 16908
FL
Other
Enumeration date
04/23/2008
Last updated
09/17/2008
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