Individual
DR. MARK BENJAMIN THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
301 STATE AVE SW, WARROAD, MN 56763-2623
(218) 386-1048
(218) 386-1049
Mailing address
PO BOX 490, WARROAD, MN 56763-0490
(218) 386-1048
(218) 386-1049
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13533
MN
Other
Enumeration date
06/09/2015
Last updated
04/22/2025
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