Provider Demographics
NPI:1871906701
Name:THOMPSON, BARBARA W (DDS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:W
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-0928
Mailing Address - Country:US
Mailing Address - Phone:334-566-7600
Mailing Address - Fax:334-566-1445
Practice Address - Street 1:1300 HIGHWAY 231 S
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3058
Practice Address - Country:US
Practice Address - Phone:334-566-7600
Practice Address - Fax:334-566-1445
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN95641223P0221X
AL62831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL185351Medicaid