Individual
KELLY LEWIS THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
216 E MAIN ST, MONCKS CORNER, SC 29461-3709
(843) 892-1104
Mailing address
216 E MAIN ST, MONCKS CORNER, SC 29461-3709
(843) 892-1104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4355
SC
Other
Enumeration date
10/05/2007
Last updated
04/09/2024
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