Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 51.033629 | OH |
NPI | 1366016529 |
---|---|
Provider Name | Kimberly Michelle Thompson |
First Address | Cincinnati, OH 45229-3014 |
Second Address | Cincinnati, OH 45225-2049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2021 |
Last Update Date | 13/05/2021 |