Individual
SUSANNY THENUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
33454 HAVLIK DR, SCAPPOOSE, OR 97056-3836
(503) 543-3136
Mailing address
33454 HAVLIK DR, SCAPPOOSE, OR 97056-3836
(503) 543-3136
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9892
OR
Other
Enumeration date
11/07/2013
Last updated
01/09/2017
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