Individual
JON MARK THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9200 113TH ST, SEMINOLE, FL 33772-2800
(573) 587-6343
Mailing address
704 OAK AVE, CLEARWATER, FL 33756
(573) 587-6343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1092
FL
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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