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Individual

JASON MARK THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
839 E GRAND AVE, ESCONDIDO, CA 92025-3401
(760) 705-1180
Mailing address
839 E GRAND AVE, ESCONDIDO, CA 92025-3401

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
09281
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
100205
CA

Other

Enumeration date
04/27/2012
Last updated
04/30/2018
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