Individual
DR. ANDREW JOHN THANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1201 10TH STREET, MENOMINEE, MI 49858
(906) 863-9203
(906) 863-9205
Mailing address
1201 10TH STREET, MENOMINEE, MI 49858
(906) 863-9203
(906) 863-9205
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901010281
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901010281
STATE LICENSE NUMBER
MI
Enumeration date
09/20/2010
Last updated
09/20/2010
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