Individual
MRS. LARISA Y THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6165 LEHMAN DR STE 100, COLORADO SPRINGS, CO 80918-5405
(719) 532-0707
Mailing address
8195 SPIRE CT, COLORADO SPRINGS, CO 80919-3829
(719) 232-9356
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
906003
CO
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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