Individual
MICHAEL GARDNER THORSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS ORTHODONTIST
Contact information
Practice address
12765 W FOREST HILL BLVD, WELLINGTON PLAZA SUITE 130, WELLINGTON, FL 33414
(561) 798-1758
(561) 798-1758
Mailing address
12765 W FOREST HILL BLVD, WELLINGTON PLAZA SUITE 130, WELLINGTON, FL 33414
(561) 798-1758
(561) 798-1758
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
FL7760
FL
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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