Individual
DR. DWIGHT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DSS
Contact information
Practice address
12 EAST BRUNSWICK, BYHALIA, MS 38611-0698
(662) 838-2163
(662) 838-7945
Mailing address
P.O. BOX 698, 12 EAST BRUNSWICK, BYHALIA, MS 38611-0698
(662) 838-2163
(662) 838-7945
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4742
TN
1223G0001X
General Practice Dentistry
Primary
3569-10
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00108254
—
MS
05
—
3226520
—
TN
Enumeration date
09/19/2005
Last updated
08/10/2011
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