Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 9878 | NC |
N | 1223P0221X | Pediatric Dentist | 9878 | NC |
NPI | 1609191584 |
---|---|
Provider Name | Yvette E Thompson |
First Address | Durham, NC 27707-0031 |
Second Address | Durham, NC 27707-0031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2010 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1223D0001X | (05) | NC |