Provider Demographics
NPI:1699096305
Name:THOMPSON, PRECIOUS KING (DDS)
Entity type:Individual
Prefix:DR
First Name:PRECIOUS
Middle Name:KING
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N LOOP 1604 W
Mailing Address - Street 2:108-234
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-4503
Mailing Address - Country:US
Mailing Address - Phone:210-884-8904
Mailing Address - Fax:
Practice Address - Street 1:1150 N LOOP 1604 W
Practice Address - Street 2:108-234
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-4503
Practice Address - Country:US
Practice Address - Phone:210-884-8904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice