| NPI | 1659561249 |
|---|---|
| Former Name | WHITNEY NICOLE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 04014118851) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14179) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2016-06-08 |