Individual
EMILY TURBEVILLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2758
Mailing address
4646 HAZELWOOD DR, JACKSON, MS 39211-5817
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
4214-21
MS
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2021
Last updated
08/12/2021
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