| Doctor Name: | DR. KURT WADE THOMPSON |
| NPI Number: | 1033207444 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS |
| License Number: | 30845 |
| Business Practice Address: | 785 Hana Way Ste 101 Folsom, CA - 95630 |
| Business Phone Number: | 9168178937 |
| Business Fax Number: | 9168178936 |
| Mailing Address: | 785 Hana Way, Ste 101 FOLSOM |
| State: | CA |
| Postal Code: | 95630 |
| Phone Number: | 9168178937 |
| Fax Number: | 9168178936 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 30845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |