Provider Demographics
NPI:1891286696
Name:THOMPSON, HANNAH LEE (DDS)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LEE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2225 LOCKSLEY WOODS DR APT G
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6159
Mailing Address - Country:US
Mailing Address - Phone:919-426-1687
Mailing Address - Fax:
Practice Address - Street 1:1619 LIKE OAK ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516
Practice Address - Country:US
Practice Address - Phone:252-728-4570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice