Provider Demographics
NPI:1811086333
Name:THOMPSON, BRANDY ANN (CDA)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MUSEUM RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8785
Mailing Address - Country:US
Mailing Address - Phone:704-873-0854
Mailing Address - Fax:
Practice Address - Street 1:318 TURNERSBURG HWY
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-2798
Practice Address - Country:US
Practice Address - Phone:704-878-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant