Individual
MRS. CAROLYN REBECCA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
811 HARRY RAYSOR DRIVE, ST MATTHEWS, SC 29135
(803) 874-4500
(803) 874-4502
Mailing address
PO BOX 425, ST MATTHEWS, SC 29135
(803) 874-4500
(803) 874-4502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3087
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z30878
—
SC
Enumeration date
12/18/2006
Last updated
07/08/2007
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