Individual
MS. SHELBY ADRIENNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA OMSA
Contact information
Practice address
1316 COFFEE RD, SUITE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Mailing address
1316 COFFEE RD, SUITE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA50815
CA
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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