Individual
DR. CORY GRANT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3015 HILLRISE DR, LAS CRUCES, NM 88011-4703
(575) 522-0454
(575) 522-3472
Mailing address
3015 HILLRISE DR, LAS CRUCES, NM 88011-4703
(575) 522-0454
(575) 522-3472
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D8066
AZ
1223G0001X
General Practice Dentistry
Primary
DD3462
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79521550
—
NM
Enumeration date
08/13/2010
Last updated
02/04/2014
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