Individual
DR. LANCE DAVIS THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
1849 NW KEARNEY ST STE 300, PORTLAND, OR 97209-1453
(503) 224-1371
(503) 224-0722
Mailing address
1849 NW KEARNEY ST STE 300, PORTLAND, OR 97209-1453
(503) 224-1371
(503) 224-0722
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D10069
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D10069
OR
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD204165
OR
Other
Enumeration date
06/26/2015
Last updated
04/29/2021
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