Individual
DR. MICHAEL ERNEST THIELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
301 STATE AVE SW, WARROAD, MN 56763-0490
(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
9514
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497745400
OFFICE NPI NUMBER
MN
Enumeration date
01/29/2007
Last updated
03/16/2018
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