| Peter Thompson, DDS | |
|
123 W 2nd St Portales NM 88130-6201 | |
| (575) 448-8863 | |
| Not Available |
| Full Name | Peter Thompson, DDS |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 123 W 2nd St, Portales, New Mexico |
| Authorized Official Name and Position | Cary Lacouture (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3035215701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Thompson, DDS 123 W 2nd St Portales NM 88130-6201 Ph: (575) 448-8863 | Peter Thompson, DDS 123 W 2nd St Portales NM 88130-6201 Ph: (575) 448-8863 |
| NPI Number | 1306415955 |
|---|---|
| Provider Enumeration Date | 06/18/2021 |
| Last Update Date | 06/18/2021 |
| Certification Date | 06/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306415955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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