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General NPI Number Information
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NPI Number | 1376091504
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Entity Type | Individual
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Provider Name | CAROLYN JO THOMPSON DMD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 1445 ENCINITAS BLVD
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City | ENCINITAS
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State | CA
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Zip | 92024-2931
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Country | US
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Telephone | 760-942-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 324 N RIOS AVE
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1242
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Country | US
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Telephone | 920-368-4667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 107088
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22158
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License Number State | FL
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