Individual
MORGAN ALEXANDRA THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
811 W GRAND RIVER AVE, PORTLAND, MI 48875-1126
(517) 647-7878
Mailing address
811 W GRAND RIVER AVE, PORTLAND, MI 48875-1126
(517) 647-7878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901021912
MI
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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