Individual
OWEN JAMES THOELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316-3123
(763) 421-5206
(763) 421-8320
Mailing address
2803 E 38TH ST, # 203, MINNEAPOLIS, MN 55406-4414
(612) 508-0170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12453
MN
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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