Provider Demographics
NPI:1356553077
Name:THOMPSON, JAMES CECIL (DDSPA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CECIL
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DDSPA
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:CECIL
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDSPA
Mailing Address - Street 1:1823CHAPELHILLROAD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-489-6256
Mailing Address - Fax:
Practice Address - Street 1:1823 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1100
Practice Address - Country:US
Practice Address - Phone:919-489-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice