# RANDALL A THOMPSON DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Camano Island Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144388075
- **Authorized official:** DR. RANDELL ARTHUR THOMPSON DDS (PRESIDENT CHAIRMAN OF THE BOARD)
- **Authorized official phone:** (360) 629-4097

## Contact information

- **Practice address:** 810 REKDAL RD, CARMANO ISLAND, WA 98282
- **Practice address phone:** (360) 629-4097
- **Practice address fax:** (360) 629-3906
- **Mailing address:** 810 REKDAL RD, CARMANO ISLAND, WA 98282
- **Mailing address phone:** (360) 629-4097
- **Mailing address fax:** (360) 629-3906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00004408 | WA | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5030911 | DSHS | WA |