Individual
DR. LARRY WAYNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1360 S WADSWORTH BLVD, #300, LAKEWOOD, CO 80232-5415
(303) 986-9505
(303) 986-2089
Mailing address
1360 S WADSWORTH BLVD, #300, LAKEWOOD, CO 80232-5415
(303) 986-9505
(303) 986-2089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104349
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02043495
—
CO
Enumeration date
04/17/2007
Last updated
07/08/2007
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