Individual
DR. BRIAN M THIELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1543 PARK PL, SUITE 300, GREEN BAY, WI 54304-1970
(920) 405-3600
(920) 405-9057
Mailing address
1543 PARK PL, SUITE 300, GREEN BAY, WI 54304-1970
(920) 405-3600
(920) 405-9057
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4725
WI
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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