Provider Demographics
NPI:1992099964
Name:DAVID W. COMPTON, DMD, MS, PC
Entity type:Organization
Organization Name:DAVID W. COMPTON, DMD, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-652-2615
Mailing Address - Street 1:10163 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5743
Mailing Address - Country:US
Mailing Address - Phone:503-652-2615
Mailing Address - Fax:503-654-7561
Practice Address - Street 1:10163 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE 450
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5743
Practice Address - Country:US
Practice Address - Phone:503-652-2615
Practice Address - Fax:503-654-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty