Individual
GLENNA S THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
107 H STREET EAST, POPLAR, MT 59255-0067
(406) 768-2179
Mailing address
PO BOX 67, POPLAR, MT 59255-0067
(406) 768-2179
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H006938
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009301
BC/BS OF MONTANA
MT
05
—
2210068
—
MT
01
—
H006938
LICENSE
AZ
Enumeration date
08/30/2018
Last updated
08/30/2018
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