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1760611875
DERRICK LANE THOMPSON
LOS ANGELES, CA
NPI
1760611875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 40893)
Enumeration Date
2009-07-09
Last Update Date
2009-07-09
Business Address
Dr. DERRICK LANE THOMPSON DDS
11645 WILSHIRE BLVD 703
LOS ANGELES, CA 90025-1708
Phone number: 310-479-4432
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Mailing Address
Dr. DERRICK LANE THOMPSON DDS
8117 W MANCHESTER AVE 387
PLAYA DEL REY, CA 90293-8745
Phone number: 310-479-4432
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