Individual
GLEN D. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
320 E ARMSTRONG AVE, PEORIA, IL 61603-3172
(309) 360-0495
Mailing address
12719 LOCUST RD, TREMONT, IL 61568-9036
(309) 925-3343
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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